Provider Demographics
NPI:1245208495
Name:NAIDORF, JOAN S (DO)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:S
Last Name:NAIDORF
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1300 PICCARD DRIVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4303
Mailing Address - Country:US
Mailing Address - Phone:301-921-7900
Mailing Address - Fax:301-921-7915
Practice Address - Street 1:4320 SEMINARY ROAD
Practice Address - Street 2:ALEXANDRIA HOSPITAL
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:703-504-3066
Practice Address - Fax:703-504-3866
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102036978207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005846111Medicaid
F41501Medicare UPIN
VA005846111Medicaid