BETHANY INGRAM

VIENNA, VA
NPI1932210259
Former NameBETHANY REVAK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: VA  0101226838)
Enumeration Date2006-08-31
Last Update Date2007-07-08
Business Address
-- BETHANY INGRAM M.D.
100 MAPLE AVE E
VIENNA, VA 22180-5723
Phone number: 703-938-5300
Mailing Address
-- BETHANY INGRAM M.D.
100 MAPLE AVE E
VIENNA, VA 22180-5723
Phone number: 703-938-5300
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