Provider Demographics
NPI:1265497861
Name:RODRIGUEZ, PATRICIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:RODRIGUEZ
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 1:3040 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 1:1635 N GEORGE MASON DR STE 170
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3633
Practice Address - Country:US
Practice Address - Phone:571-350-8400
Practice Address - Fax:703-528-0338
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052032174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1265497861Medicaid
VA018520F90Medicare PIN
VAE58716Medicare UPIN