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General NPI Number Information
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NPI Number | 1932307352
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Entity Type | Organization
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Legal Business Name | DOMINGO SUATENGCO, MD, PC
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 3700 JOSEPH SIEWICK DR SUITE 206
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City | FAIRFAX
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State | VA
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Zip | 22033-1744
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Country | US
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Telephone | 703-476-0901
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Fax | 703-264-9762
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Provider Business Mailing Address
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Address Line | 3700 JOSEPH SIEWICK DR SUITE 206
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City | FAIRFAX
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State | VA
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Zip | 22033-1744
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Country | US
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Telephone | 703-476-0901
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Fax | 703-264-9762
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Authorized Official
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Title or Position | DOCTOR
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Name | DOMINGO SUATENGCO
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Credential |
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Telephone | 703-476-0901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101-041522
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License Number State | VA
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