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Organization

BELLE HAVEN FAMILY MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WARREN BASIL SHAFFER M.D. (MEDICAL DIRECTOR)
(703) 212-7397
Entity
Organization

Contact information

Practice address
2867 DUKE ST, ALEXANDRIA, VA 22314-4512
(703) 212-7397
(703) 212-7399
Mailing address
2867 DUKE ST, ALEXANDRIA, VA 22314-4512
(703) 212-7397
(703) 212-7399

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0101057177
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101057177
STATE LICENSE NUMBER
VA
Enumeration date
02/20/2007
Last updated
03/07/2023
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