Provider Demographics
NPI:1417015074
Name:WINTER, DAVID BROOKS (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BROOKS
Last Name:WINTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 N KENMORE ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2226
Mailing Address - Country:US
Mailing Address - Phone:703-524-7728
Mailing Address - Fax:703-524-4577
Practice Address - Street 1:927 N KENMORE ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2226
Practice Address - Country:US
Practice Address - Phone:703-524-7728
Practice Address - Fax:703-524-4577
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102034822208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
D72424Medicare UPIN
W1421811Medicare ID - Type Unspecified