Provider Demographics
NPI:1952401440
Name:VIRTUDES, JULIETA O (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIETA
Middle Name:O
Last Name:VIRTUDES
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:PO BOX 37090
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3090
Mailing Address - Country:US
Mailing Address - Phone:703-295-9360
Mailing Address - Fax:703-295-9369
Practice Address - Street 1:3600 JOSEPH SIEWICK DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1709
Practice Address - Country:US
Practice Address - Phone:703-391-3129
Practice Address - Fax:703-295-9369
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037673207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCK142-0001OtherCAREFIRST
VA033578OtherTRIGON
VA493822OtherNCPPO
VA050053984OtherRAILROAD MEDICARE
VA1952401440Medicaid
VA033578OtherANTHEM
VA301520OtherAMERIGROUP
DCK142-0001OtherCAREFIRST
VA033578OtherANTHEM
DC463793F89Medicare ID - Type Unspecified