Organization
COMMONWEALTH EAR, NOSE & THROAT ASSOCIATES, LLC
Active
Other names
Stephen M Bane MD PLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL J EKINS (OFFICE MANAGER)
(703) 878-0777
Entity
Organization
Contact information
Practice address
2280 OPITZ BLVD, SUITE 340, WOODBRIDGE, VA 22191
(703) 878-0777
(703) 583-1777
Mailing address
2280 OPITZ BLVD, SUITE 340, WOODBRIDGE, VA 22191
(703) 878-0777
(703) 583-1777
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6500226
—
VA
01
—
DC5029
RAILROAD MEDICARE
VA
Enumeration date
07/08/2006
Last updated
05/06/2009
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