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Individual

JOSEPHINE TRACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D, MPH

Contact information

Practice address
8008 WESTPARK DR, MC LEAN, VA 22102-3109
(860) 884-5508
Mailing address
9500 CLARKS CROSSING RD, VIENNA, VA 22182-1926
(860) 884-5508

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101267049
VA
207L00000X
Anesthesiology Physician
125065504
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/02/2013
Last updated
06/21/2021
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