Provider Demographics
NPI:1851503841
Name:CASADABAN, BRIDGETT L (MD)
Entity Type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:L
Last Name:CASADABAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 PARK AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3305
Mailing Address - Country:US
Mailing Address - Phone:434-924-8344
Mailing Address - Fax:
Practice Address - Street 1:431 PARK AVE STE 300
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3305
Practice Address - Country:US
Practice Address - Phone:434-924-8344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101247224207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics