Provider Demographics
NPI:1043576804
Name:ROSAL, LINDY MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:LINDY
Middle Name:MICHELLE
Last Name:ROSAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDY
Other - Middle Name:MICHELLE
Other - Last Name:BARROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3040 WILLIAMS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4618
Mailing Address - Country:US
Mailing Address - Phone:571-350-8400
Mailing Address - Fax:703-940-8692
Practice Address - Street 1:2280 OPITZ BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3330
Practice Address - Country:US
Practice Address - Phone:571-350-8400
Practice Address - Fax:703-897-7938
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME118159208600000X
DCMD210002208208600000X
MDD87648208600000X
FLME 118159208D00000X
VA0101271795208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice