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General NPI Number Information
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NPI Number | 1255431375
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Entity Type | Individual
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Provider Name | HUMBERTO MARCELO ANDREOLI M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 8308 OLD COURTHOUSE RD SUITE A
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City | VIENNA
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State | VA
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Zip | 22182-3863
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Country | US
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Telephone | 703-531-1090
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Fax | 703-531-1091
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Provider Business Mailing Address
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Address Line | 8308 OLD COURTHOUSE RD SUITE A
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City | VIENNA
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State | VA
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Zip | 22182-3863
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Country | US
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Telephone | 703-531-1090
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Fax | 703-531-1091
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101055708
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License Number State | VA
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