Individual
BENJAMIN DREW TATOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-5492
Mailing address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-5492
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024178330
VA
363LG0600X
Gerontology Nurse Practitioner
0024178330
VA
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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