Provider Demographics
NPI:1083893226
Name:SIPES, JAMES N (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:N
Last Name:SIPES
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 1:2946 SLEEPY HOLLOW RD
Mailing Address - Street 2:SUITE 4C
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2003
Mailing Address - Country:US
Mailing Address - Phone:703-533-2012
Mailing Address - Fax:703-533-0136
Practice Address - Street 1:2946 SLEEPY HOLLOW RD
Practice Address - Street 2:SUITE 4C
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2003
Practice Address - Country:US
Practice Address - Phone:703-533-2012
Practice Address - Fax:703-533-0136
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101020675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541692086OtherTIN
VA541692086OtherTIN
VA430816S63Medicare PIN