Individual
DR. PETER REID KONGSTVEDT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11951 FREEDOM DR, RESTON, VA 20190-5640
(703) 947-2489
Mailing address
1464 BUENA VISTA AVE, MC LEAN, VA 22101-3510
(703) 442-8908
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101046055
VA
Other
Enumeration date
05/31/2006
Last updated
07/08/2007
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