Provider Demographics
NPI:1598743908
Name:KAVJIAN, DAVID ALAN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALAN
Last Name:KAVJIAN
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 1:4801 KENMORE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1163
Mailing Address - Country:US
Mailing Address - Phone:703-461-7100
Mailing Address - Fax:703-823-7858
Practice Address - Street 1:4801 KENMORE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1163
Practice Address - Country:US
Practice Address - Phone:703-461-7100
Practice Address - Fax:703-823-7858
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040813207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
006497853OtherMEDALLION MEDICAL
046068053384OtherBCBS
1173529004OtherCIGNA HEALTHCARE
25530018OtherCAPITAL CARE
27306OtherGALT EMPLOYEES HEALTH
540911540OtherTRICARE
1700800OtherUNITED HEALTH CARE
27306OtherALLIANCE PPO
290290OtherAMERIGOUP MEDICAID
VA006497853Medicaid
046068OtherHEALTHKEEPERS ANTHEM
27306OtherNDIPA
502707OtherAETNA US HEALTHCARE
200013382OtherTRAVELERS MEDICARE
25530018OtherCAREFIRST
4091886OtherAETNA MANAGED CHOICE