Provider Demographics
NPI:1346689338
Name:SERSHON, ROBERT AXEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:AXEL
Last Name:SERSHON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2445 ARMY NAVY DR STE 307
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2998
Mailing Address - Country:US
Mailing Address - Phone:703-892-6500
Mailing Address - Fax:703-769-8486
Practice Address - Street 1:2445 ARMY NAVY DR STE 307
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2998
Practice Address - Country:US
Practice Address - Phone:703-892-6500
Practice Address - Fax:703-769-8486
Is Sole Proprietor?:No
Enumeration Date:2013-06-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101264747207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAFS7648718OtherDEA