Provider Demographics
NPI:1043302615
Name:YAGER, JONATHAN EE (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:EE
Last Name:YAGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 HAMAKER CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5216
Mailing Address - Country:US
Mailing Address - Phone:703-641-9161
Mailing Address - Fax:703-641-0383
Practice Address - Street 1:3023 HAMAKER CT
Practice Address - Street 2:SUITE 100
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5216
Practice Address - Country:US
Practice Address - Phone:703-641-9161
Practice Address - Fax:703-641-0383
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237803207RC0000X
NC200300917207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
2131272OtherMDIPA
541977219OtherUNITED HEALTHCARE
177226OtherANTHEM
2131272OtherMAMSI
3780441OtherAETNA HMO
541977219OtherAETNA HMO
6069437OtherCIGNA
177226OtherANTHEM HEALTHKEEPERS PLUS
541977219OtherCIGNA
2518145OtherUNITED HEALTHCARE
541977219OtherNALC AFFORDABLE
541977219OtherMDIPA
5726OtherCAREFIRST
VA010145104Medicaid
7529665OtherAETNA PPO
0010OtherCAREFIRST
I278892Medicare UPIN
VAC08696Medicare ID - Type Unspecified
177226OtherANTHEM HEALTHKEEPERS PLUS
541977219OtherUNITED HEALTHCARE