MEDICARE: DR. DOUGLAS S PRICE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0101044217	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	071110	OTHER	VA	ANTHEM/MANASSAS
2	4301809	OTHER	VA	AETNA HMO/PPO
3	92130003	OTHER	VA	CAREFIRST
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	071114	OTHER	VA	ANTHEM/WARRENTON
6	34541	OTHER	VA	MAMSI
7	5972512001	OTHER	VA	CIGNA

General Provider Information

NPI Number	:	1306841127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS S PRICE MD

Provider Business Mailing Address
First Line	:	8640 SUDLEY RD STE 201
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20110-4404
Country	:	US
Telephone Number	:	703-368-6819
Fax Number	:	703-330-2923

Provider Business Practice Location Address
First Line	:	8640 SUDLEY RD STE 201
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20110-4404
Country	:	US
Telephone Number	:	703-368-6819
Fax Number	:	703-330-2923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	10/04/2012

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Directions to “ DR. DOUGLAS S PRICE MD” Practice Location

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