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Individual

FREDERICK W PARKER III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10322 BRISTOW CENTER DR, BRISTOW, VA 20136-2201
(571) 284-4230
(703) 257-1495
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(703) 368-3161
(703) 368-2498

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101024081
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
19220089291
VA
05
5633397
VA
Enumeration date
07/28/2005
Last updated
04/21/2021
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