OrganizationActive
Advanced Digestive Care, LLC
NPI 1629462171 · Clinical Pathology/Laboratory Medicine Physician · Annandale, VA
Provider details
- NPI number
- 1629462171
- Entity type
- Organization
- Primary specialty
- Clinical Pathology/Laboratory Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Martin Prosky, Administrator
Practice location
3301 Woodburn Rd Ste 107
Annandale, VA 22003-1297
Phone: (703) 876-0437
Fax: (703) 876-0722
Mailing address
3301 Woodburn Rd Ste 107
Annandale, VA 22003-1297
Registry dates
- Enumerated
- 2015-03-23
- Last updated
- 2023-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.