Provider Demographics
NPI:1376515759
Name:EGGE, ALAN C (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:C
Last Name:EGGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8140 ASHTON AVE
Mailing Address - Street 2:STE 120
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-5698
Mailing Address - Country:US
Mailing Address - Phone:703-361-3128
Mailing Address - Fax:703-361-3670
Practice Address - Street 1:8140 ASHTON AVE
Practice Address - Street 2:STE 120
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-5698
Practice Address - Country:US
Practice Address - Phone:703-361-3128
Practice Address - Fax:703-361-3670
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2011-05-02
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Provider Licenses
StateLicense IDTaxonomies
VA0101036560207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006362303Medicaid
VA180000108Medicare PIN
VAB60171Medicare UPIN
VA006362303Medicaid