Individual
MARYANNE TARKINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8503 ARLINGTON BLVD, #310, FAIRFAX, VA 22031-4628
(703) 208-4200
(703) 876-1799
Mailing address
PO BOX 327, MCLEAN, VA 22101
(703) 346-3321
(703) 356-3739
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101041526
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290991
ANTEHM SATELLITE OFFICE
—
01
—
440309
ANTHEM MAIN OFFICE
—
01
—
502651
NCPPO
—
01
—
839434
AETNA
—
01
—
B131/0006
CAREFIRST BCBS
—
Enumeration date
08/29/2005
Last updated
04/17/2008
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