Dermatology Specialists Of Virginia PC
Dermatology in Reston, VA. Organization (NPI-2).
NPI number1083688238
StatusActive
Last updated in NPPESOct 7, 2010
Details
- NPI
- 1083688238
- Entity type
- Organization (NPI-2)
- Legal business name
- Dermatology Specialists Of Virginia PC
- Organization subpart
- No
- Enumeration date
- Feb 15, 2006
- Last updated
- Oct 7, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
Other names
- Sebastien Dermatology PC (Former Legal Business Name)
Practice location
1800 Town Center DrSte 415
Reston, VA 20190
Phone 703-709-1492 · Fax 703-709-5111
Mailing address
1800 Town Center DrSte 415
Reston, VA 20190
Phone 703-709-1492 · Fax 703-709-5111
Authorized official
Theodore Stewart Sebastien
Ceo President
7037091492
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