Gartside, Roberta Lee
Gartside, Roberta Lee is an sole proprietor health care provider with primary practice located at 1800 Town Center Dr Suite 412, Reston VA 20190-3215. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as her primary health care specialty. Gartside, Roberta Lee can be contacted via phone (703) 742-8004.Contact Information
Primary practice address
1800 Town Center Dr Suite 412
Reston VA 20190-3215
Phone: (703) 742-8004
Fax: (703) 742-3749
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 0101042741 | Virginia |
Profile Details
NPI number | 1508901844 |
---|---|
LBN Legal business name | Gartside, Roberta Lee |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 21st, 2007 |
Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1508901844 | NPPES |
Virginia | MEDICAID | 6941648 |
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