Healthcare Provider Details

I. General information

NPI: 1740231554
Provider Name (Legal Business Name): DAVID L POSTELNEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 OPITZ BLVD
WOODBRIDGE VA
22191-3311
US

IV. Provider business mailing address

3992 BRIARBUSH WAY
FAIRFAX VA
22031-3853
US

V. Phone/Fax

Practice location:
  • Phone: 703-670-1313
  • Fax: 800-536-8431
Mailing address:
  • Phone: 703-503-8403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101051870
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: