Provider Demographics
NPI:1568440170
Name:FRUMAN, STUART ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:ALAN
Last Name:FRUMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3015 WILLIAMS DR
Mailing Address - Street 2:#200
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4623
Mailing Address - Country:US
Mailing Address - Phone:703-641-9133
Mailing Address - Fax:703-280-5098
Practice Address - Street 1:3015 WILLIAMS DR
Practice Address - Street 2:#200
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4623
Practice Address - Country:US
Practice Address - Phone:703-641-9133
Practice Address - Fax:703-280-5098
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010508772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7232268Medicaid
VA7232268Medicaid
088114F99Medicare ID - Type Unspecified