Provider Demographics
NPI:1689619389
Name:BABCOCK, MARIAPAZ (DO)
Entity Type:Individual
Prefix:
First Name:MARIAPAZ
Middle Name:
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 FAIRFAX DR 400
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-5860
Mailing Address - Country:US
Mailing Address - Phone:703-738-4380
Mailing Address - Fax:703-642-1876
Practice Address - Street 1:3031 JAVIER RD.
Practice Address - Street 2:STE. 100
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:703-914-8000
Practice Address - Fax:703-560-8214
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201122208100000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC003352K57Medicare PIN