Stanley Idiculla DPM

NPI 1043274368 - Podiatrist - 213ES0131X

NPI Details
NPI 1043274368
Gender Male
Enumeration Date 04/13/2006
Last Updated 12/18/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
112 ELDEN ST
SUITE D
HERNDON VA, 20170-4874, US
Phone (703) 437-5353
Fax
Business Location
112 ELDEN ST
SUITE D
HERNDON VA, 20170-4874, US
Phone (703) 437-5353
Fax
Toxanomy
Taxonomy Code 213ES0131X
License State Virginia
License Number XXXX
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According to our database, Dr. Stanley Idiculla DPM NPI is 1043274368, taxonomy code is 213ES0131X and license number is XXXX, license state is located at Virginia. Stanley Idiculla DPM physically located at 112 Elden St, Herndon VA, 20170-4874. NPI Number Stanley Idiculla DPM has the Individual type.

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1043274368 NPI number is provided on an as is basis without warranty of any kind. 1043274368 is maintained by the National Plan & Provider Enumeration System. The contents of Stanley Idiculla DPM are for informational purposes only.