Provider Demographics
NPI:1053645978
Name:POPE, DAVID J (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:POPE
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Gender:M
Credentials:PA
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Mailing Address - Street 1:9625 SURVEYOR COURT
Mailing Address - Street 2:SUITE 320
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110
Mailing Address - Country:US
Mailing Address - Phone:571-921-4877
Mailing Address - Fax:571-208-0585
Practice Address - Street 1:9625 SURVEYOR COURT
Practice Address - Street 2:SUITE 320
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:571-921-4877
Practice Address - Fax:571-208-0585
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2022-05-27
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Provider Licenses
StateLicense IDTaxonomies
VA0110003156363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1053645978Medicaid
VAVVF270D686Medicare PIN