Therese Soballe Cermak, MD
Pathology, Anatomic Pathology & Clinical Pathology in Reston, VA. Individual provider (NPI-1).
NPI number1346480936
StatusActive
Last updated in NPPESJul 19, 2023
Details
- NPI
- 1346480936
- Entity type
- Individual (NPI-1)
- Name
- Therese Soballe Cermak
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 23, 2009
- Certification date
- Jul 19, 2023
- Last updated
- Jul 19, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | MD035880 | DC | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | |
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 0101053571 | VA |
Practice location
1850 Town Center PkwyReston, VA 20190-3204
Phone 703-689-9093 · Fax 703-639-9580
Mailing address
Po Box 745344Atlanta, GA 30374-5344
Phone 703-689-9093 · Fax 703-639-9580
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