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General NPI Number Information
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NPI Number | 1477077071
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Entity Type | Organization
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Legal Business Name | DULLES DERMATOLOGY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 24430 STONE SPRINGS BLVD STE 275
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City | DULLES
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State | VA
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Zip | 20166-2247
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Country | US
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Telephone | 703-450-5959
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Fax | 703-450-4800
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Provider Business Mailing Address
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Address Line | 24430 STONE SPRINGS BLVD SUITE 275
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City | DULLES
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State | VA
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Zip | 20166-2462
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Country | US
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Telephone | 844-357-3376
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MAGDALENA POLITANO
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Credential |
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Telephone | 844-357-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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