Rodriguez, Kelly M

Rodriguez, Kelly M is an individual health care provider with primary practice located at 20905 Professional Plz Ste 330, Ashburn VA 20147-7783. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Rodriguez, Kelly M can be contacted via phone (703) 726-0003.

Contact Information

Primary practice address
20905 Professional Plz Ste 330 Ashburn VA 20147-7783
Phone: (703) 726-0003
Fax: (703) 726-6444
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101231491 Virginia

Profile Details

NPI number 1568455103
LBN Legal business name Rodriguez, Kelly M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Oct 18th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568455103 NPPES
Virginia MEDICAID 05647096
Virginia Other P00010206

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