Provider Demographics
NPI:1396778502
Name:ANEZ, OSVALDO CESPEDES (MD FACS)
Entity type:Individual
Prefix:DR
First Name:OSVALDO
Middle Name:CESPEDES
Last Name:ANEZ
Suffix:
Gender:M
Credentials:MD FACS
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Mailing Address - Street 1:6035 BURKE CENTRE PKWY
Mailing Address - Street 2:SUITE #390
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3750
Mailing Address - Country:US
Mailing Address - Phone:703-978-1196
Mailing Address - Fax:703-978-7762
Practice Address - Street 1:462 HERNDON PKWY
Practice Address - Street 2:#101
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5233
Practice Address - Country:US
Practice Address - Phone:703-956-9743
Practice Address - Fax:703-956-6749
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2010-01-26
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Provider Licenses
StateLicense IDTaxonomies
VA010135038208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B93132Medicare UPIN
071550Medicare PIN