Provider Demographics
NPI:1962626838
Name:NAGEL, DOUGLAS OWEN
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:OWEN
Last Name:NAGEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46960 CEDAR LAKE PLZ
Mailing Address - Street 2:SUITE 150
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-8657
Mailing Address - Country:US
Mailing Address - Phone:703-444-7613
Mailing Address - Fax:703-444-7615
Practice Address - Street 1:46960 CEDAR LAKE PLZ
Practice Address - Street 2:SUITE 150
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-8657
Practice Address - Country:US
Practice Address - Phone:703-444-7613
Practice Address - Fax:703-444-7615
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556119111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician