Provider Demographics
NPI:1700257839
Name:INFECTIOUS DISEASES PHYSICIANS, INC
Entity type:Organization
Organization Name:INFECTIOUS DISEASES PHYSICIANS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:PORETZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSHA
Authorized Official - Phone:703-560-7900
Mailing Address - Street 1:3289 WOODBURN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-7347
Mailing Address - Country:US
Mailing Address - Phone:703-560-7900
Mailing Address - Fax:703-560-8408
Practice Address - Street 1:3289 WOODBURN RD STE 200
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7347
Practice Address - Country:US
Practice Address - Phone:703-560-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172994363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty