MEDICARE: MICHAEL ALAN REDDING 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	207Q00000X	Family Medicine Physician	0101043490	VA

General Provider Information

NPI Number	:	1457310120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ALAN REDDING M.D.

Provider Business Mailing Address
First Line	:	6476 LANDSDOWNE CTR
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22315-5003
Country	:	US
Telephone Number	:	703-282-2243
Fax Number	:

Provider Business Practice Location Address
First Line	:	6476 LANDSDOWNE CTR
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22315-5003
Country	:	US
Telephone Number	:	703-282-2243
Fax Number	:

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	06/08/2022

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