Provider Demographics
NPI:1528229622
Name:NAKAO, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:NAKAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2280 OPITZ BLVD
Mailing Address - Street 2:STE 320
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3362
Mailing Address - Country:US
Mailing Address - Phone:703-523-9750
Mailing Address - Fax:855-210-2388
Practice Address - Street 1:2296 OPITZ BLVD
Practice Address - Street 2:STE 260
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3300
Practice Address - Country:US
Practice Address - Phone:703-491-8058
Practice Address - Fax:540-628-2322
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2017-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT193203208600000X
VA0101254104208600000X
NC2015-02293208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVA408AMedicare PIN