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Individual

PATRICK L NEUSTATTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1301 SAM PERRY BLVD, FREDERICKSBURG, VA 22401
(540) 741-1061
(540) 741-1096
Mailing address
1301 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-8420
(540) 741-1061
(540) 741-1096

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101039127
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00090768
AETNA CAP
VA
05
005636973
VA
01
0101039127
LICENSE
VA
01
0898100
AETNA HMO
VA
01
285302
ANTHEM
VA
01
4092057
AETNA NON HMO
VA
01
82929
MAMSI
VA
01
CA9037
MCR RAILROAD GROUP
VA
01
CO2375
MEDICARE GROUP
VA
Enumeration date
01/23/2006
Last updated
07/30/2019
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