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Organization

COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH

Active
Other names
Loudoun County Health Department
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID P GOODFRIEND M.D. (DIRECTOR)
(703) 771-5829
Entity
Organization

Contact information

Practice address
102 HERITAGE WAY NE, 1ST FLOOR SUITE #100, LEESBURG, VA 20176
(703) 777-0236
(703) 771-5393
Mailing address
1 HARRISON ST SE, LEESBURG, VA 20175
(703) 771-5829
(703) 771-5023

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004975677
VA
Enumeration date
09/19/2006
Last updated
07/21/2011
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