Individual
DONALD TRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3225 GALLOWS RD, FAIRFAX, VA 22031-4872
(571) 472-0221
(571) 472-0241
Mailing address
3225 GALLOWS RD, FAIRFAX, VA 22031-4872
(571) 472-0221
(571) 472-0241
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
0101258401
VA
Other
Enumeration date
11/09/2005
Last updated
09/24/2018
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