Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 0101236049 | VA |
NPI | 1053405688 |
---|---|
Provider Name | Dr. Paul Steven Modlinger |
First Address | Fairfax, VA 22030-4738 |
Second Address | Fairfax, VA 22030-4738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 26/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010083753 | (05) | VA |
010083770 | (05) | VA |
010085683 | (05) | VA |
010085691 | (05) | VA |
010085721 | (05) | VA |
010085811 | (05) | VA |
010085829 | (05) | VA |
010085837 | (05) | VA |
010085845 | (05) | VA |
010085870 | (05) | VA |
010085918 | (05) | VA |
010085934 | (05) | VA |
010124743 | (05) | VA |
010184983 | (05) | VA |
2128905 | MAMSI (01) | |
47430007 | CAREFIRST (01) | |
9202002 | CIGNA (01) | |
H12340 | (02) |