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Individual

HOMER E KNUDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8308 OLD COURTHOUSE RD, SUITE A, VIENNA, VA 22182-3863
(703) 790-9440
(703) 790-5359
Mailing address
8308 OLD COURTHOUSE RD, SUITE A, VIENNA, VA 22182-3863
(703) 790-9440
(703) 790-5359

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23301
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07-00455
UNITED HEALTHCARE PIN
VA
01
0785845
AETNA HMO
VA
01
088399
ANTHEM PPO/HEALTHKEEPERS
VA
01
10316
UNICARE
VA
01
1463350004
CIGNA PIN
VA
01
27007
OPTIMUMCHOICE/MAMSI/MDIPA
VA
01
4087
CAREFIRST PPO/ BLUECHOICE
VA
01
4087376
AETNA PPO
VA
05
6260730
VA
01
99214
GUARDIAN
VA
Enumeration date
07/06/2006
Last updated
07/08/2007
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