# ENDOCRINOLOGY AND DIABETES ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710925474
- **Authorized official:** ROBERT LIVELY (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (540) 741-1141

## Contact information

- **Practice address:** 1101 SAM PERRY BLVD, SUITE 305, FREDERICKSBURG, VA 22401-4467
- **Practice address phone:** (540) 374-3290
- **Practice address fax:** (540) 374-3289
- **Mailing address:** 1101 SAM PERRY BLVD, SUITE 305, FREDERICKSBURG, VA 22401-4467
- **Mailing address phone:** (540) 374-3290
- **Mailing address fax:** (540) 374-3289

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 0101239833 | VA | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 02/20/2008