Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD038927 | DC |
NPI | 1073770145 |
---|---|
Provider Name | John Jairo Reyes-Castano |
First Address | Springfield, VA 22150-1826 |
Second Address | Springfield, VA 22150-1826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2008 |
Last Update Date | 08/01/2022 |