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General NPI Number Information
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NPI Number | 1518977263
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Entity Type | Individual
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Provider Name | VESNA MRZLJAK MD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 6300 STEVENSON AVE UNIT A
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City | ALEXANDRIA
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State | VA
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Zip | 22304-3576
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Country | US
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Telephone | 703-751-6060
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Fax | 703-751-6870
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Provider Business Mailing Address
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Address Line | 6300 STEVENSON AVE UNIT A
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City | ALEXANDRIA
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State | VA
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Zip | 22304-3576
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Country | US
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Telephone | 703-751-6060
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Fax | 703-751-6870
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 0101035385
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | 0101035385
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License Number State | VA
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