Individual
DR. DAVID A SHOSTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
8348 TRAFORD LANE, STE 302, SPRINGFIELD, VA 22152-1650
(703) 451-8816
(703) 451-9766
Mailing address
8348 TRAFORD LANE, STE 302, SPRINGFIELD, VA 22152-1650
(703) 451-8816
(703) 451-9766
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810000940
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007745061
—
VA
01
—
164270
TRICARE
VA
01
—
A3370001
CAREFIRST
VA
Enumeration date
03/17/2006
Last updated
08/28/2019
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