Individual
DR. SONYA NADINE BETHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7440 SPRING VILLAGE DR, SPRINGFIELD, VA 22150-4446
(703) 923-4644
(703) 923-4625
Mailing address
5525 RESEARCH PARK DR, 4TH FLOOR, BALTIMORE, MD 21228-4873
(703) 923-4644
(703) 923-4625
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101041548
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-24040
EVERCARE
—
01
—
1063466076
BCBS-VA
—
01
—
350541
ANTHEM BCBS
—
01
—
5374-0020
BCBS OF DC
—
Enumeration date
05/22/2006
Last updated
05/06/2015
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