Individual
ANITA M MAYBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
381 STUYVESANT ST STE 1, WARRENTON, VA 20186-2400
(540) 347-4410
Mailing address
PO BOX 223323, CHANTILLY, VA 20153-3323
(540) 349-0595
(540) 349-0587
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
0101230734
VA
208D00000X
General Practice Physician
Primary
0101230734
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010167108
—
VA
05
—
010206405
—
VA
Enumeration date
07/28/2006
Last updated
10/10/2025
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