MEDICARE: WILLIAM EDWARD BOOKER DC

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	111N00000X	Chiropractor	0104001505	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	610987	OTHER	VA	UNITEDHEALTHCARE
2	291395	OTHER	VA	ANTHEM BCBS

General Provider Information

NPI Number	:	1477764967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM EDWARD BOOKER DC

Provider Business Mailing Address
First Line	:	8301 BELLA VISTA TER
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-5504
Country	:	US
Telephone Number	:	301-567-4114
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 N QUINCY ST
Second Line	:	130
City	:	ARLINGTON
State	:	VA
Zip	:	22203-1999
Country	:	US
Telephone Number	:	703-527-5492
Fax Number	:	703-527-5624

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

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Directions to “ WILLIAM EDWARD BOOKER DC” Practice Location

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