Individual
SAMUEL HEISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
20905 PROFESSIONAL PLZ STE 110, ASHBURN, VA 20147-3409
(703) 726-0003
(703) 726-6444
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
0110-005856
VA
Other
Enumeration date
07/19/2017
Last updated
06/05/2023
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