Provider Demographics
NPI:1154631356
Name:TROELL, PETER THOMAS JR (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:THOMAS
Last Name:TROELL
Suffix:JR
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6092 9TH PL N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1608
Mailing Address - Country:US
Mailing Address - Phone:202-384-7395
Mailing Address - Fax:
Practice Address - Street 1:10777 MAIN ST
Practice Address - Street 2:SUITE 211
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6903
Practice Address - Country:US
Practice Address - Phone:703-246-2433
Practice Address - Fax:703-385-3681
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012426232083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine