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1164657342
ALEX DERTAD MANGUIKIAN
FAIRFAX, VA
NPI
1164657342
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207W00000X Ophthalmology
(Licence: VA 0101253390)
Enumeration Date
2009-05-18
Last Update Date
2013-03-19
Business Address
-- ALEX DERTAD MANGUIKIAN M.D., Ph.D.
9936 MAIN ST
FAIRFAX, VA 22031-3901
Phone number: 703-591-4884
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Mailing Address
-- ALEX DERTAD MANGUIKIAN M.D., Ph.D.
9936 MAIN ST
FAIRFAX, VA 22031-3901
Phone number: 703-591-4884
Copy
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