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General NPI Number Information
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NPI Number | 1700257839
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASES PHYSICIANS, INC
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 3289 WOODBURN RD STE 200
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City | ANNANDALE
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State | VA
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Zip | 22003-7347
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Country | US
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Telephone | 703-560-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 3289 WOODBURN RD STE 200
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City | ANNANDALE
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State | VA
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Zip | 22003-7347
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Country | US
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Telephone | 703-560-7900
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Fax | 703-560-8408
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Authorized Official
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Title or Position | COO
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Name | STEVE PORETZ
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Credential | RN, MSHA
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Telephone | 703-560-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024172994
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License Number State | VA
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