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General NPI Number Information
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NPI Number | 1609001072
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Entity Type | Individual
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Provider Name | SAMANTHA ALYSE SHLAKMAN MD
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Gender | Female
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 501 CHURCH ST NE SUITE 217
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City | VIENNA
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State | VA
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Zip | 22180-4734
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Country | US
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Telephone | 202-421-7408
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 CONNECTICUT AVE NW STE 1225
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City | WASHINGTON
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State | DC
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Zip | 20036-1718
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Country | US
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Telephone | 202-421-7408
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD037466
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101248565
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License Number State | VA
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