Provider Demographics
NPI:1649261819
Name:PARTANEN, DOUGLAS MATTHEW (PHYSCIAN ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:MATTHEW
Last Name:PARTANEN
Suffix:
Gender:M
Credentials:PHYSCIAN ASSISTANT
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:177 MILLRACE RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-8534
Mailing Address - Country:US
Mailing Address - Phone:540-226-7391
Mailing Address - Fax:
Practice Address - Street 1:9501 FARRELL RD
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5901
Practice Address - Country:US
Practice Address - Phone:703-805-0599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002298363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical