Individual
ELENA SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14139 POTOMAC MILLS RD, WOODBRIDGE, VA 22192-4644
(703) 359-7878
Mailing address
1150 VARNUM ST NE, WASHINGTON, DC 20017-2104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MTL002853
DC
Other
Enumeration date
06/10/2015
Last updated
12/08/2021
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