Individual
DR. MELODY ROSE HEISKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8316 ARLINGTON BLVD STE 300, FAIRFAX, VA 22031-5216
(703) 573-2432
Mailing address
2005 BEACON PL, RESTON, VA 20191-4843
(404) 290-1244
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
002165
GA
208000000X
Pediatrics Physician
Primary
0101245374
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101245374
VIRGINIA LICENSE
VA
Enumeration date
01/29/2008
Last updated
02/18/2022
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