Individual
DR. MADGE BRUCE VANNESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11 CRESCENT CT, STERLING, VA 20164-1601
(703) 906-2826
(770) 345-0163
Mailing address
11 CRESCENT CT, STERLING, VA 20164-1601
(703) 906-2826
(770) 345-0163
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101-033905
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101-033905
STATE LICENSE NUMBER
VA
Enumeration date
08/08/2013
Last updated
08/08/2013
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