Individual
THEODORE E TEMOSHCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2501 PARKERS LN, ALEXANDRIA, VA 22306-3209
(703) 664-7264
(703) 664-7075
Mailing address
3207 NORWICH TER, ALEXANDRIA, VA 22309-2129
(703) 360-7266
(703) 664-7075
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110000047
VA
Other
Enumeration date
06/15/2010
Last updated
06/15/2010
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