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General NPI Number Information
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NPI Number | 1376794644
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Entity Type | Organization
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Legal Business Name | ROBERT N DEANGELIS MD LTD
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 8346 TRAFORD LN
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1600
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Country | US
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Telephone | 703-451-8777
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Fax | 703-451-6936
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Provider Business Mailing Address
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Address Line | 8346 TRAFORD LN
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1600
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Country | US
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Telephone | 703-451-8777
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Fax | 703-451-6936
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT N DEANGELIS SR.
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Credential | M.D.
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Telephone | 703-451-8777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 0101057902
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License Number State | VA
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