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1457305633

NPI Code Detail

MEDICARE: DR. C ANDERSON ENGH JR. M.D.

MEDICARE: DR. C ANDERSON ENGH JR. M.D.

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	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	0101041575	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1475047	OTHER		CIGNA ID
2	5016308	OTHER		FIRST HEALTH
3	00098	OTHER		UNITED ID
4	502344	OTHER		NCPPO
5	4304586	OTHER		AETNA PPO
6	212639	OTHER		MAMSI ID
7	0499710	OTHER		AETNA HMO
8	148820100	OTHER		DEPT OF LABOR ID
9	25090029	OTHER		BLUE CROSS/BLUE SHIELD
10	099069	OTHER		ANTHEM ID

General Provider Information

NPI Number	:	1457305633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. C ANDERSON ENGH JR. M.D.

Provider Business Mailing Address
First Line	:	2800 S SHIRLINGTON RD STE 1000
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22206-3614
Country	:	US
Telephone Number	:	703-769-8423
Fax Number	:	703-799-5989

Provider Business Practice Location Address
First Line	:	2800 S SHIRLINGTON RD STE 1100
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22206-3605
Country	:	US
Telephone Number	:	703-892-6500
Fax Number	:	703-521-3415

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	05/12/2023

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Directions to “ DR. C ANDERSON ENGH JR. M.D.” Practice Location

Language	Start Address	Practice Location

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