MEDICARE: DR. DAVID EDWARD CANTER PH.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	103TC0700X	Clinical Psychologist	0810004399	VA

General Provider Information

NPI Number	:	1841540655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID EDWARD CANTER PH.D.

Provider Business Mailing Address
First Line	:	8214 COOPER ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22309-1052
Country	:	US
Telephone Number	:	703-799-5851
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 N PERSHING DR
Second Line	:	SUITE 201
City	:	ARLINGTON
State	:	VA
Zip	:	22201-1428
Country	:	US
Telephone Number	:	703-772-8677
Fax Number	:

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

Provider Enumeration Date	:	09/19/2012
Last Update Date	:	09/19/2012

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