Provider Demographics
NPI:1700106424
Name:S. CARRINGTON, INC
Entity Type:Organization
Organization Name:S. CARRINGTON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUNN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MALAKA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:703-232-5776
Mailing Address - Street 1:14904 JEFFERSON DAVIS HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3908
Mailing Address - Country:US
Mailing Address - Phone:703-490-8171
Mailing Address - Fax:703-490-8172
Practice Address - Street 1:14904 JEFFERSON DAVIS HWY STE 105
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3908
Practice Address - Country:US
Practice Address - Phone:703-490-8171
Practice Address - Fax:703-490-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301025213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty