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General NPI Number Information
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NPI Number | 1154487007
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Entity Type | Organization
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Legal Business Name | ENDOCRINE AND DIABETES CENTER P.C.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 301 MAPLE AVE W SUITE 120
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City | VIENNA
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State | VA
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Zip | 22180-4301
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Country | US
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Telephone | 703-938-8885
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Fax | 703-242-2437
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Provider Business Mailing Address
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Address Line | 301 MAPLE AVE W SUITE 120
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City | VIENNA
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State | VA
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Zip | 22180-4301
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Country | US
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Telephone | 703-938-8885
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Fax | 703-242-2437
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALI M SAFA
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Credential | M.D.
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Telephone | 703-938-8885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 101040528
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License Number State | VA
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