Provider Demographics
NPI:1386662286
Name:KEMPF, PHILLIP WILLIAM (M D)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:WILLIAM
Last Name:KEMPF
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 N GEORGE MASON DR STE 220
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3606
Mailing Address - Country:US
Mailing Address - Phone:703-525-3069
Mailing Address - Fax:703-525-3850
Practice Address - Street 1:1635 N GEORGE MASON DR STE 220
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3606
Practice Address - Country:US
Practice Address - Phone:703-525-3069
Practice Address - Fax:703-525-3850
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048122207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA237058OtherANTHEM BLUE SHIELD
VA416548OtherMAMSI, ALLIANCE PPO
DCB7980001OtherCARE FIRST
VA416548OtherMAMSI, ALLIANCE PPO
VA015298A08Medicare ID - Type UnspecifiedIND PROVIDER NUMBER