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General NPI Number Information
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NPI Number | 1962395616
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Entity Type | Organization
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Legal Business Name | 46&2 HEALTHCARE, LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 3025 HAMAKER CT STE 350
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City | FAIRFAX
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State | VA
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Zip | 22031-2243
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Country | US
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Telephone | 703-573-6400
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Fax | 703-641-5821
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Provider Business Mailing Address
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Address Line | 5211 SPRING BRANCH BLVD
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City | DUMFRIES
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State | VA
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Zip | 22025-3048
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Country | US
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Telephone | 317-460-1940
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID DEWITTE
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Credential | MD
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Telephone | 317-460-1940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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