Organization
ALEXANDRIA ADULT PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KANTHA R STOLL M.D. (OWNER/PHYSICIAN)
(703) 212-4825
Entity
Organization
Contact information
Practice address
5249 DUKE ST, STE 100D, ALEXANDRIA, VA 22304-2926
(703) 212-4825
(703) 212-4829
Mailing address
5249 DUKE ST, STE 100D, ALEXANDRIA, VA 22304-2926
(703) 212-4825
(703) 212-4829
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101057481
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D10147191
—
VA
Enumeration date
12/17/2007
Last updated
09/10/2008
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