Individual
HIWOT B DESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19455 DEERFIELD AVE STE 201, LANSDOWNE, VA 20176-8102
(703) 723-3670
(703) 723-8336
Mailing address
PO BOX 381468, GERMANTOWN, TN 38183-1468
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101236951
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010112109
—
VA
05
—
1558321091
—
VA
Enumeration date
03/27/2006
Last updated
02/05/2026
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