Provider Demographics
NPI:1922092220
Name:HORNER, CYNTHIA P (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:P
Last Name:HORNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 HERNDON PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5276
Mailing Address - Country:US
Mailing Address - Phone:703-481-1505
Mailing Address - Fax:703-742-8793
Practice Address - Street 1:555 HERNDON PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5276
Practice Address - Country:US
Practice Address - Phone:703-481-1505
Practice Address - Fax:703-742-8793
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053614207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA05628784Medicaid
G43744Medicare UPIN
VA05628784Medicaid