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General NPI Number Information
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NPI Number | 1922282771
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Entity Type | Individual
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Provider Name | REBECCA OGUR SINCLAIR M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 14806 BLACKBURN RD STREET LIGHT COMMUNITY OUTREACH MINISTRIES
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City | WOODBRIDGE
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State | VA
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Zip | 22191
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Country | US
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Telephone | 703-491-2288
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Fax | 703-491-2272
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Provider Business Mailing Address
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Address Line | 12146 DARNLEY ROAD
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City | WOODBRIDGE
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State | VA
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Zip | 22192
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Country | US
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Telephone | 703-819-9243
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | VA0101236634
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License Number State | VA
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