Provider Demographics
NPI:1013028794
Name:INFECTIOUS DISEASES ASSOCIATES PC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASES ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SANTE
Authorized Official - Last Name:SYMINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-339-3524
Mailing Address - Street 1:8988 LORTON STATION BLVD
Mailing Address - Street 2:#204
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4733
Mailing Address - Country:US
Mailing Address - Phone:703-339-3524
Mailing Address - Fax:703-339-9157
Practice Address - Street 1:8988 LORTON STATION BLVD
Practice Address - Street 2:#204
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4733
Practice Address - Country:US
Practice Address - Phone:703-339-3524
Practice Address - Fax:703-339-9157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5238550001Medicare NSC
DC183023Medicare ID - Type UnspecifiedMEDICARE GROUP