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General NPI Number Information
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NPI Number | 1144214222
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASES & MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 1635 N GEORGE MASON DR SUITE 180
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City | ARLINGTON
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State | VA
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Zip | 22205-3601
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Country | US
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Telephone | 703-276-7798
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Fax | 703-276-0433
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Provider Business Mailing Address
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Address Line | 1635 N GEORGE MASON DR SUITE 180
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City | ARLINGTON
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State | VA
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Zip | 22205-3601
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Country | US
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Telephone | 703-276-7798
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Fax | 703-276-0433
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | DR. M (MARGARET) ELLEN JAY
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Credential | PHD
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Telephone | 301-384-9008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 0101042196
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 0101038151
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License Number State | VA
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