Organization
LOUDOUN RHEUMATOLOGY CENTER, PC
Active
Organization
LOUDOUN RHEUMATOLOGY CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER ODUTOLA M.D. (MEDICAL DIRECTOR)
(703) 723-3398
Entity
Organization
Contact information
Practice address
19465 DEERFIELD AVE, SUITE 309, LANSDOWNE, VA 20176-8446
(703) 723-3398
Mailing address
19500 SANDRIDGE WAY STE 170, LANSDOWNE, VA 20176-3692
(703) 723-3398
(703) 723-9128
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
0101234395
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376748426
—
VA
Enumeration date
06/19/2007
Last updated
12/05/2022
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