Provider Demographics
NPI:1730172180
Name:FIEDLER, JOYCE PASTORE (MD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:PASTORE
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOYCE
Other - Middle Name:ANN
Other - Last Name:PASTORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:113 RED MAPLE WAY
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-3742
Mailing Address - Country:US
Mailing Address - Phone:850-865-2002
Mailing Address - Fax:
Practice Address - Street 1:7500 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1301
Practice Address - Country:US
Practice Address - Phone:703-681-7242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101840480207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine