Basic Information
| Provider Information | |||||||||
| NPI: | 1518936244 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PELFREY | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | ALLEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3700 FETTLER PARK DRIVE | ||||||||
| Address2: | DUMFRIES HEALTH CLINIC | ||||||||
| City: | DUMFRIES | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7034417500 | ||||||||
| FaxNumber: | 4349462766 | ||||||||
| Practice Location | |||||||||
| Address1: | 3700 FETTLER PARK DRIVE | ||||||||
| Address2: | DUMFRIES HEALTH CLINIC | ||||||||
| City: | DUMFRIES | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7034417500 | ||||||||
| FaxNumber: | 4349462766 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2006 | ||||||||
| LastUpdateDate: | 04/26/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101044523 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1518936244 | 05 | VA | MEDICAID |