Provider Demographics
NPI:1427170372
Name:ROLAND, MIRIAM WOODALL (MD PC)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:WOODALL
Last Name:ROLAND
Suffix:
Gender:F
Credentials:MD PC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:200 LITTLE FALLS ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4302
Mailing Address - Country:US
Mailing Address - Phone:703-241-1275
Mailing Address - Fax:703-532-4201
Practice Address - Street 1:200 LITTLE FALLS ST
Practice Address - Street 2:SUITE 205
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4302
Practice Address - Country:US
Practice Address - Phone:703-241-1275
Practice Address - Fax:703-532-4201
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA320972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
00B976M95Medicare PIN
B94627Medicare UPIN