Individual
REVERLY JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3300
(703) 776-4001
(703) 776-7113
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
0101242960
VA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
102792
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
49159
MN
Other
Enumeration date
11/01/2006
Last updated
07/20/2022
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