Provider Demographics
NPI:1467666412
Name:GOLD, DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:GOLD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8206 LEESBURG PIKE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2614
Mailing Address - Country:US
Mailing Address - Phone:703-942-8828
Mailing Address - Fax:703-942-8829
Practice Address - Street 1:8321 OLD COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3817
Practice Address - Country:US
Practice Address - Phone:703-942-8828
Practice Address - Fax:703-942-8829
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor