Individual
AMY L TRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
493 BLACKWELL RD, SUITE 202, WARRENTON, VA 20186-2639
(540) 347-4400
(540) 341-4766
Mailing address
PO BOX 748613 SUITE 202, ATLANTA, GA 30384-8613
(434) 295-1000
(540) 341-4766
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101231302
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10035414
—
VA
Enumeration date
08/25/2006
Last updated
11/05/2024
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