Provider Demographics
NPI:1336142777
Name:SAGER, DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:SAGER
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 1:1800 TOWN CENTER DR
Mailing Address - Street 2:STE 313
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3200
Mailing Address - Country:US
Mailing Address - Phone:703-471-5340
Mailing Address - Fax:703-437-6177
Practice Address - Street 1:1800 TOWN CENTER DR
Practice Address - Street 2:STE 313
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3200
Practice Address - Country:US
Practice Address - Phone:703-471-5340
Practice Address - Fax:703-437-6177
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033182207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC136471Medicare PIN
A83669Medicare UPIN