Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 0401-005620 | VA |
Y | 213EG0000X | General Practice | 0401-005620 | VA |
NPI | 1003039140 |
---|---|
Provider Name | Dr. David Paul Sibley |
First Address | Fairfax, VA 22033-1744 |
Second Address | Fairfax, VA 22033-1744 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |