Provider Demographics
NPI:1255427266
Name:PACE, JOHN H (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:PACE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8708 SUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4405
Mailing Address - Country:US
Mailing Address - Phone:703-530-1226
Mailing Address - Fax:703-530-1228
Practice Address - Street 1:8081 INNOVATION PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4867
Practice Address - Country:US
Practice Address - Phone:571-472-7000
Practice Address - Fax:571-472-7001
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101048460207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010189861Medicaid
VA180527OtherANTHEM
VA008163E50Medicare ID - Type Unspecified