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General NPI Number Information
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NPI Number | 1952141277
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Entity Type | Organization
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Legal Business Name | DOCTALK LLC
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Dates
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Enumeration Date | 05/27/2024
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 45929 MARIES RD STE 100
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City | STERLING
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State | VA
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Zip | 20166-9299
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Country | US
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Telephone | 703-400-5314
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Fax |
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Provider Business Mailing Address
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Address Line | 45929 MARIES RD STE 100
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City | STERLING
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State | VA
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Zip | 20166-9299
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Country | US
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Telephone | 703-400-5314
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DR. LAEEQ A. BUTT
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Credential | MD
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Telephone | 703-400-5314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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