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NPI Code Detail

MEDICARE: DR. JOHN VITARELLO III MD, MS

MEDICARE: DR. JOHN VITARELLO III MD, MS
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
1207R00000XInternal Medicine Physician0101285772VA
2207RC0000XCardiovascular Disease Physician0101285772VA

General Provider Information

NPI Number : 1811556657
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN VITARELLO III MD, MS
Provider Business Mailing Address
First Line : 1830 TOWN CENTER DR STE 405
Second Line :
City : RESTON
State : VA
Zip : 20190-3218
Country : US
Telephone Number : 703-481-9191
Fax Number : 571-423-5082
Provider Business Practice Location Address
First Line : 1830 TOWN CENTER DR STE 405
Second Line :
City : RESTON
State : VA
Zip : 20190-3218
Country : US
Telephone Number : 703-481-9191
Fax Number : 571-423-5082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2019
Last Update Date : 09/05/2025

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