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Organization

ENDOCRINOLOGY AND INFECTIOUS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANTONIO PASTOR M.D. (PRESIDENT)
(703) 430-6211
Entity
Organization

Contact information

Practice address
21475 RIDGETOP CIR STE 350, STERLING, VA 20166-6580
(703) 430-6211
(703) 430-1414
Mailing address
6035 BURKE CENTRE PKWY, BURKE, VA 22015-3750
(703) 978-1196
(703) 978-7762

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101057623
VA
207RI0200X
Infectious Disease Physician
0101053112
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CK5247
MEDICARE, RAILROAD
Enumeration date
07/03/2007
Last updated
08/06/2014
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