MEDICARE: JOANN PFUNDSTEIN M.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	207R00000X	Internal Medicine Physician	0101052483	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A582-0003	OTHER		BCBS PLANS

General Provider Information

NPI Number	:	1912900598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN PFUNDSTEIN M.D.

Provider Business Mailing Address
First Line	:	3020 HAMAKER COURT
Second Line	:	SUITE B102
City	:	FAIRFAX
State	:	VA
Zip	:	22031-2220
Country	:	US
Telephone Number	:	571-327-5107
Fax Number	:	571-327-5786

Provider Business Practice Location Address
First Line	:	3020 HAMAKER CT
Second Line	:	SUITE B102
City	:	FAIRFAX
State	:	VA
Zip	:	22031-2238
Country	:	US
Telephone Number	:	571-327-5107
Fax Number	:	571-327-5786

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	09/12/2016

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