Individual
RONA HARTHILL EARLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3020 HAMAKER CT STE B102, FAIRFAX, VA 22031-2220
(703) 573-4072
(703) 572-2153
Mailing address
3020 HAMAKER CT STE B102, FAIRFAX, VA 22031-2220
(703) 573-4072
(703) 572-2153
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101041264
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004573175
AETNA
VA
01
—
113266
ANTHEM BCBS
VA
01
—
17143
NCPPO
VA
01
—
3804
CAREFIRST BCBS
VA
05
—
6021620
—
VA
01
—
CIGNA
541932424 0002
VA
Enumeration date
12/04/2006
Last updated
07/08/2007
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