Organization
STEVENSON PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSARIO G DANCEL (MD)
(703) 823-2400
Entity
Organization
Contact information
Practice address
6000 STEVENSON AVE, STE 104, ALEXANDRIA, VA 22304-3577
(703) 823-2400
(703) 823-2013
Mailing address
6000 STEVENSON AVE, STE 104, ALEXANDRIA, VA 22304-3577
(703) 823-2400
(703) 823-2013
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
0101032546
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090804
AETNA US HEALTHCARE HMO
VA
01
—
231691
ANTHEM HEALTH KEEPERS PLU
VA
01
—
407481
AETNA US HEALTHCARE PPO
VA
01
—
58692
AMERIGROUP
VA
Enumeration date
02/20/2007
Last updated
08/22/2020
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