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General NPI Number Information
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NPI Number | 1821107764
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Entity Type | Organization
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Legal Business Name | ASHBURN MEDICAL CENTER PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 42882 TRURO PARISH DRIVE SUITE 201 ASHBURN MEDICAL CENTER PC
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City | ASHBURN
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State | VA
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Zip | 20148
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Country | US
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Telephone | 703-729-1660
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Fax | 703-729-1668
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Provider Business Mailing Address
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Address Line | 42882 TRURO PARISH DRIVE SUITE 201 ASHBURN MEDICAL CENTER PC
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City | ASHBURN
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State | VA
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Zip | 20148
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Country | US
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Telephone | 703-729-1660
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Fax | 703-729-1668
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. JAMES DITARANTO
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Credential | DO
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Telephone | 703-729-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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