Provider Demographics
NPI:1265418917
Name:REDINGTON, KATHLEEN MARIE (MD)
Entity type:Individual
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First Name:KATHLEEN
Middle Name:MARIE
Last Name:REDINGTON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1390 CHAIN BRIDGE RD
Mailing Address - Street 2:PMB 82
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3904
Mailing Address - Country:US
Mailing Address - Phone:703-748-0032
Mailing Address - Fax:703-761-0319
Practice Address - Street 1:10560 MAIN ST
Practice Address - Street 2:SUITE 510
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7182
Practice Address - Country:US
Practice Address - Phone:703-748-0032
Practice Address - Fax:703-761-0319
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
DC20453207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F69833Medicare UPIN