MEDICARE: LORETO P VIRTUDES 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	207R00000X	Internal Medicine Physician	0101045677	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	210772	OTHER		ANTHEM BCBS
2	090227	OTHER		ANTHEM HEALTHKEEPER
3	1021764	OTHER		CIGNA
4	474704	OTHER	VA	AETNA
5	817893	OTHER		ALLIANCE
6	1383508	OTHER		FIRST HEALTH
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	210772	OTHER	VA	BCBS
9	A0660001	OTHER		CAREFIRST BCBS
10	A0660001	OTHER		CAREFIRST BLUECHOICE
11	10719011	OTHER		UNITED HEALTHCARE
12	299294	OTHER		GREATWEST
13	817893	OTHER		MDIPA

General Provider Information

NPI Number	:	1487663407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORETO P VIRTUDES MD

Provider Business Mailing Address
First Line	:	3783 FETTLER PARK DR
Second Line	:
City	:	DUMFRIES
State	:	VA
Zip	:	22025-1946
Country	:	US
Telephone Number	:	703-441-1276
Fax Number	:	703-441-0097

Provider Business Practice Location Address
First Line	:	3783 FETTLER PARK DR
Second Line	:
City	:	DUMFRIES
State	:	VA
Zip	:	22025-1946
Country	:	US
Telephone Number	:	703-441-1276
Fax Number	:	703-441-0097

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	05/05/2008

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Directions to “ LORETO P VIRTUDES MD” Practice Location

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