Provider Demographics
NPI:1518937473
Name:DEMOZ, ELIAS G (MD)
Entity Type:Individual
Prefix:
First Name:ELIAS
Middle Name:G
Last Name:DEMOZ
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 1:6521 ARLINGTON BLVD
Mailing Address - Street 2:STE 410
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3009
Mailing Address - Country:US
Mailing Address - Phone:703-532-4357
Mailing Address - Fax:866-578-7925
Practice Address - Street 1:6521 ARLINGTON BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3016
Practice Address - Country:US
Practice Address - Phone:703-532-4357
Practice Address - Fax:866-578-5925
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235406207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010208009Medicaid
185607OtherANTHEM BCBS
I20501Medicare UPIN
VA00W644N01Medicare PIN