Wattenmaker, Ian Michael

Wattenmaker, Ian Michael is an individual health care provider with primary practice located at 19450 Deerfield Avenue, Suite 200 , Leesburg VA 20176-6821. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Wattenmaker, Ian Michael can be contacted via phone (703) 777-1553.

Contact Information

Primary practice address
19450 Deerfield Avenue, Suite 200 Leesburg VA 20176-6821
Phone: (703) 777-1553
Fax: (703) 777-5524
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 0101049672 Virginia

Profile Details

NPI number 1629077854
LBN Legal business name Wattenmaker, Ian Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Mar 18th, 2024 - about 2 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 1629077854 NPPES
Virginia MEDICAID 30015845120002
Virginia MEDICAID 1629077854

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