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General NPI Number Information
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NPI Number | 1245413111
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Entity Type | Organization
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Legal Business Name | MIRIAM WOODALL ROLAND MD PC
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 200 LITTLE FALLS ST SUITE 205
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City | FALLS CHURCH
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State | VA
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Zip | 22046
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Country | US
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Telephone | 703-241-1275
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Fax | 703-532-4201
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Provider Business Mailing Address
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Address Line | 6437 TUCKER AVE
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City | MCLEAN
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State | VA
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Zip | 22101
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Country | US
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Telephone | 703-241-1275
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIRIAM WOODALL ROLAND
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Credential | MD
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Telephone | 703-893-4734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 32097
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License Number State | VA
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