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Individual

DR. CARL P BONTEMPO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
(703) 776-7113
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(703) 698-8525
(703) 849-1918

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101020737
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006060986
VA
01
011551
ANTHEM/TRIGON BCBS
01
060005779
MEDICARE RAILROAD
01
22447
MAMSI/ALLIANCE
01
4091345
AETNA PPO
01
486335
AETNA HMO
01
502853
NCPPO
01
541042964
HEALTHNET/TRICARE/CHAMPUS
01
6975-0002
CAREFIRST BC/BS
Enumeration date
07/08/2005
Last updated
10/04/2021
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