Provider Demographics
NPI:1124006788
Name:SIMS, DODD A (MD)
Entity Type:Individual
Prefix:
First Name:DODD
Middle Name:A
Last Name:SIMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1500 N BEAUREGARD ST
Mailing Address - Street 2:STE 110
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1715
Mailing Address - Country:US
Mailing Address - Phone:703-370-9003
Mailing Address - Fax:703-370-2849
Practice Address - Street 1:4660 KENMORE AVE STE 710
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1306
Practice Address - Country:US
Practice Address - Phone:703-370-9002
Practice Address - Fax:703-370-2849
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038074207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA110236764OtherRAILROAD MEDICARE
VAF660-0001OtherCAREFIRST BC/BS
VAB744-0028OtherBCBS
VA61950Medicare UPIN
VAF660-0001OtherCAREFIRST BC/BS