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Organization
ALEXANDRIA PERINATAL DIAGNOSTIC CENTER
Active
Organization
ALEXANDRIA PERINATAL DIAGNOSTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH H KOZLOFF FACHE (ADMINISTRATOR INOVA ALEXANDRIA HOSP)
(703) 504-3167
Entity
Organization
Contact information
Practice address
4320 SEMINARY ROAD, INOVA ALEXANDRIA HOSPITAL DIAGNOSTIC CENTER, ALEXANDRIA, VA 22304-1535
(703) 504-7868
(703) 504-7733
Mailing address
2876 GUARDIAN LANE, VIRGINIA BEACH, VA 23452-7327
(757) 463-5240
(757) 463-6572
Taxonomy
Speciality
Code
Description
License number
State
207SC0300X
Clinical Cytogenetics Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2504
CAREFIRST
VA
Enumeration date
06/07/2006
Last updated
04/20/2008
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