Provider Demographics
NPI:1235170853
Name:STANFORD, JULIA (MD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:STANFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 WOODBURN RD STE 306
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-7307
Mailing Address - Country:US
Mailing Address - Phone:703-810-7166
Mailing Address - Fax:703-348-8418
Practice Address - Street 1:3301 WOODBURN RD STE 306
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7307
Practice Address - Country:US
Practice Address - Phone:703-810-7166
Practice Address - Fax:703-348-8418
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231599208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB751P61Medicare ID - Type Unspecified
VAH66016Medicare UPIN