Provider Demographics
NPI:1366580425
Name:SIMPAO-IGNACIO, ROSARIO D (MD)
Entity type:Individual
Prefix:
First Name:ROSARIO
Middle Name:D
Last Name:SIMPAO-IGNACIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7906 ANDRUS RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3168
Mailing Address - Country:US
Mailing Address - Phone:703-780-1120
Mailing Address - Fax:703-780-0958
Practice Address - Street 1:7906 ANDRUS RD
Practice Address - Street 2:SUITE 10
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3168
Practice Address - Country:US
Practice Address - Phone:703-780-1120
Practice Address - Fax:703-780-0958
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101037520207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C62813Medicare UPIN