Individual
JUSTIN DANIEL SHORTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4910 MASSACHUSETTS AVE NW, STE 21, WASHINGTON, DC 20016-4360
(202) 686-6700
(202) 464-0208
Mailing address
4910 MASSACHUSETTS AVE NW, STE 21, WASHINGTON, DC 20016-4360
(202) 686-6700
(202) 464-0208
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0101281873
VA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
MD500002813
DC
Other
Enumeration date
04/14/2019
Last updated
09/18/2024
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