Provider Demographics
NPI:1265593388
Name:DIABETES & ENDOCRINE ASSOCIATES, PC
Entity type:Organization
Organization Name:DIABETES & ENDOCRINE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:COO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-823-9570
Mailing Address - Street 1:6300 STEVENSON AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3576
Mailing Address - Country:US
Mailing Address - Phone:703-823-9570
Mailing Address - Fax:703-823-9573
Practice Address - Street 1:6300 STEVENSON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3576
Practice Address - Country:US
Practice Address - Phone:703-823-9570
Practice Address - Fax:703-823-9573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041845207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty