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General NPI Number Information
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NPI Number | 1962857318
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Entity Type | Organization
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Legal Business Name | JOANN PFUNDSTEIN, MD, LLC
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Dates
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Enumeration Date | 05/03/2016
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Last Update Date | 08/08/2016
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Provider Practice Location Address
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Address Line | 3020 HAMAKER CT SUITE B102
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City | FAIRFAX
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State | VA
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Zip | 22031-2238
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Country | US
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Telephone | 571-422-9324
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 HAMAKER CT SUITE B102
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City | FAIRFAX
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State | VA
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Zip | 22031-2238
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Country | US
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Telephone | 571-422-9324
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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. JOANN PFUNDSTEIN
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Credential | M.D.
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Telephone | 571-422-9324
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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 | 0101052483
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License Number State | VA
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