MEDICARE: DR. CURTIS C. MARGERUM D.C.

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	111N00000X	Chiropractor	0104000973	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	093882	OTHER	VA	ANTHEM BC/BS
2	2431906	OTHER	VA	AETNA
3	4465301	OTHER	VA	AETNA

General Provider Information

NPI Number	:	1962586800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CURTIS C. MARGERUM D.C.

Provider Business Mailing Address
First Line	:	18 LUDWELL LN
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-8514
Country	:	US
Telephone Number	:	549-659-0115
Fax Number	:

Provider Business Practice Location Address
First Line	:	7770 RICHMOND HWY STE D
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-2859
Country	:	US
Telephone Number	:	703-360-1011
Fax Number	:	703-360-1075

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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