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General NPI Number Information
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NPI Number | 1962315382
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Entity Type | Organization
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Legal Business Name | EVERLINE PROFESSIONALS, P.A
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 8320 OLD COURTHOUSE RD STE 401
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City | VIENNA
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State | VA
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Zip | 22182-3848
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Country | US
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Telephone | 347-218-0393
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Fax |
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Provider Business Mailing Address
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Address Line | 102 S UNION ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3324
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DOUGLAS ELWOOD
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Credential | MD
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Telephone | 347-218-0393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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