Provider Demographics
NPI:1255360541
Name:WASHINGTON-ALSTON, LOUISE CAROLYN (MD)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:CAROLYN
Last Name:WASHINGTON-ALSTON
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 1:6372 MECHANICSVILLE TPKE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-4705
Mailing Address - Country:US
Mailing Address - Phone:804-730-4690
Mailing Address - Fax:804-559-0333
Practice Address - Street 1:6372 MECHANICSVILLE TPKE
Practice Address - Street 2:SUITE 103
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-4705
Practice Address - Country:US
Practice Address - Phone:804-730-4690
Practice Address - Fax:804-559-0333
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046419208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA74209OtherSENTARA
VA4139089OtherAETNA LIFE
VA254777OtherMAMSI
VA79169OtherSOUTHERN HEALTH SERVICES
VA006711758Medicaid
VA103171OtherANTHEM BCBS OF VA
VA5832832OtherCIGNA
VA4139089OtherAETNA HMO
VAB08169Medicare UPIN
VA4139089OtherAETNA HMO