MEDICARE: DR. BETH LYN DENNIS 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	207Q00000X	Family Medicine Physician	0101048409	VA

General Provider Information

NPI Number	:	1538150347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETH LYN DENNIS MD

Provider Business Mailing Address
First Line	:	8419 WENDELL DR
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22308-2157
Country	:	US
Telephone Number	:	703-619-7062
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 FETTLER PARK
Second Line	:	DUMFRIES HEALTH CENTER
City	:	DUMFRIES
State	:	VA
Zip	:	22025
Country	:	US
Telephone Number	:	703-441-7500
Fax Number	:

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

Provider Enumeration Date	:	11/01/2005
Last Update Date	:	04/10/2013

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