Individual
THERESE SOBALLE CERMAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1850 TOWN CENTER PKWY, RESTON, VA 20190-3204
(703) 689-9093
(703) 639-9580
Mailing address
PO BOX 745344, ATLANTA, GA 30374-5344
(703) 689-9093
(703) 639-9580
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0101053571
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD035880
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/23/2009
Last updated
07/19/2023
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