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Dr. Maria Pettit Canter
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Maria Pettit Canter |
| Gender: | F |
| Provider License Number If Given: | 101239731 |
NPI Information:
| NPI: | 1497749907 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 4/17/2020 |
Provider Business Mailing Address:
| Address: | 224D CORNWALL ST NW STE 403 Leesburg, VA 20176 |
| Phone Number: | 7037376001 |
| Fax Number: | 7034436717 |
Provider Business Practice Location Address:
| Address: | 1860 TOWN CENTER DR STE 140 Reston, VA 20190 |
| Phone Number: | 329352397 |
| Fax Number: | 5715264393 |
Provider Taxonomy:
| Primary: | 207VF0040X |
| Secondary (if any): | 2088F0040X |
| State: | VA |
