Provider Demographics
NPI:1679664601
Name:ARTHRITIS AND RHEUMATIC DISEASE ASSOCIATES PC
Entity Type:Organization
Organization Name:ARTHRITIS AND RHEUMATIC DISEASE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:I
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-425-4435
Mailing Address - Street 1:2730 UNIVERSITY BLVD W STE 310
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1990
Mailing Address - Country:US
Mailing Address - Phone:301-942-7600
Mailing Address - Fax:703-573-7767
Practice Address - Street 1:3027 JAVIER RD STE 2
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:301-942-7600
Practice Address - Fax:703-573-7767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101030269207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
210210OtherTRIGON FEP
333779OtherALLIANCE GEHA
4279696OtherAETNA US HEALTHCARE
VA065856OtherBCBS
110176686OtherRAILROAD MEDICARE
333779OtherALLIANCE GEHA
VA=========OtherTRICARE
VAC09778Medicare PIN
4279696OtherAETNA US HEALTHCARE
VA5833094Medicaid