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General NPI Number Information
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NPI Number | 1912091463
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Entity Type | Individual
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Provider Name | THOMAS ANTHONY RAKOWSKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 1635 NORTH GEORGE MASON DRIVE SUITE 215
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City | ARLINGTON
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State | VA
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Zip | 22205-3606
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Country | US
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Telephone | 703-841-0707
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Fax | 703-841-0718
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Provider Business Mailing Address
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Address Line | 3930 WALNUT STREET SUITE 101
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City | FAIRFAX
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State | VA
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Zip | 22030-4738
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Country | US
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Telephone | 703-246-9246
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Fax | 703-246-9257
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 0101020916
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License Number State | VA
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