Provider Demographics
NPI:1396886396
Name:PINELL-SALLES, PAULA E (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:E
Last Name:PINELL-SALLES
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 1:2901 TELESTAR CT.
Mailing Address - Street 2:#300
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1363
Mailing Address - Country:US
Mailing Address - Phone:703-591-1688
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:2901 TELESTAR CT
Practice Address - Street 2:#200
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1260
Practice Address - Country:US
Practice Address - Phone:703-573-3494
Practice Address - Fax:703-573-5353
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245557207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD417913700Medicaid
VA1396886396Medicaid
VAP01010624OtherRAILROAD MEDICARE
DCP00748034OtherRAILROAD MEDICARE
DC074310400Medicaid
VA020188T55Medicare PIN
DCP00748034OtherRAILROAD MEDICARE