1518968601 NPI number — ROBERT ALAN BALL MD

Table of content: ROBERT ALAN BALL MD (NPI 1518968601)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518968601 NPI number — ROBERT ALAN BALL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BALL
Provider First Name:
ROBERT
Provider Middle Name:
ALAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518968601
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8503 ARLINGTON BLVD
Provider Second Line Business Mailing Address:
#310
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22031-4628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-208-4200
Provider Business Mailing Address Fax Number:
703-876-1799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8503 ARLINGTON BLVD
Provider Second Line Business Practice Location Address:
#310
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22031-4628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-208-4200
Provider Business Practice Location Address Fax Number:
703-876-1799
Provider Enumeration Date:
08/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  0101047799 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4239817 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: N1900012 . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 188945 . This is a "ANTHEM PROSPERITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00303129 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1224147 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 192389 . This is a "ANTHEM FAIR OAKS" identifier . This identifiers is of the category "OTHER".




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