MEDICARE: DR. CAREN KIESWETTER 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	207V00000X	Obstetrics & Gynecology Physician	0101056552	VA

General Provider Information

NPI Number	:	1952479479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAREN KIESWETTER MD

Provider Business Mailing Address
First Line	:	2041 N GLEBE RD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-2226
Country	:	US
Telephone Number	:	703-527-3880
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 N GLEBE RD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-2226
Country	:	US
Telephone Number	:	703-527-3880
Fax Number	:

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	07/08/2007

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