Provider Demographics
NPI:1093804239
Name:MEDLEY, SYLVIA RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:RENEE
Last Name:MEDLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 HALF STREET SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003
Mailing Address - Country:US
Mailing Address - Phone:202-546-4504
Mailing Address - Fax:866-639-4761
Practice Address - Street 1:915 HALF STREET SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003
Practice Address - Country:US
Practice Address - Phone:202-546-4504
Practice Address - Fax:866-639-4761
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD036273207R00000X
DCMD034445207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCY58800001OtherCAREFIRST BLUE CROSS BLUE SHIELD
DC001991914007OtherUNITED HEALTHCARE
DC3850189OtherCIGNA
DC4284019OtherAETNA
DC001991914007OtherUNITED HEALTHCARE