Provider Demographics
NPI:1710078951
Name:INFECTIOUS DISEASE CONSULTANTS
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEINROTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-246-9560
Mailing Address - Street 1:11211 WAPLES MILL ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7406
Mailing Address - Country:US
Mailing Address - Phone:703-246-9560
Mailing Address - Fax:703-246-9564
Practice Address - Street 1:11211 WAPLES MILL ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7406
Practice Address - Country:US
Practice Address - Phone:703-246-9560
Practice Address - Fax:703-246-9564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA894158Medicare ID - Type Unspecified