Provider Demographics
NPI:1164458501
Name:REESE, WHITNEY ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ELIZABETH
Last Name:REESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9844B MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-3908
Mailing Address - Country:US
Mailing Address - Phone:703-913-0273
Mailing Address - Fax:703-273-4133
Practice Address - Street 1:9844B MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3908
Practice Address - Country:US
Practice Address - Phone:703-273-3359
Practice Address - Fax:703-273-4133
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047347207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF66254Medicare UPIN
VARE151826Medicare ID - Type Unspecified