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Individual

DR. MARK J TEDESCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, MPH

Contact information

Practice address
3990 FETTLER PARK DR, SUITE B, DUMFRIES, VA 22025-1997
(703) 680-3489
Mailing address
5089 WILLOW OAK PL, MONTCLAIR, VA 22025-3010
(703) 680-3489

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD043004E
PA

Other

Enumeration date
07/21/2006
Last updated
11/17/2011
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