ANNANDALE OB GYN NPI 1811057102

NPI Information

  • NPI: 1811057102
  • Provider Name: ANNANDALE OB GYN
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 49D2179581
  • Address: 4208 EVERGREEN LN
    STE 213
    ANNANDALE, VA
    ZIP 22003
  • Phone: (703) 642-7522

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NPI Details

ANNANDALE OB GYN is a specialist in Annandale, VA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ANNANDALE OB GYN NPI is 1811057102. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4208 EVERGREEN LN
STE 213
ANNANDALE, VA
ZIP 22003-235
Phone: (703) 642-7522

The provider's authorized official is Anna Nha-khanh Le .
The authorized official title is Director and has the following contact phone number (703) 642-7522.

The CLIA number assigned to this NPI record is 49D2179581 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/9/2006 and was last updated on 7/1/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistVIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1010179785MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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