Individual
DR. KYLE SAMUEL SCHOLNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
10875 MAIN ST STE 212, FAIRFAX, VA 22030
(203) 494-6958
Mailing address
10875 MAIN ST STE 212, FAIRFAX, VA 22030-4732
(203) 494-6958
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103301195
VA
213E00000X
Podiatrist
01545
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078772800
—
MD
Enumeration date
04/19/2011
Last updated
08/14/2018
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