Provider Demographics
NPI:1619967767
Name:DEVAN, VAS (MD)
Entity Type:Individual
Prefix:DR
First Name:VAS
Middle Name:
Last Name:DEVAN
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 1:19455 DEERFIELD AVE
Mailing Address - Street 2:STE 206
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8100
Mailing Address - Country:US
Mailing Address - Phone:703-858-9691
Mailing Address - Fax:703-858-9618
Practice Address - Street 1:19455 DEERFIELD AVE
Practice Address - Street 2:STE 206
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8100
Practice Address - Country:US
Practice Address - Phone:703-858-9608
Practice Address - Fax:703-858-9618
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048805207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5853559Medicaid
DCBSDCOtherBS OF DC
B12443Medicare UPIN
290013319Medicare ID - Type UnspecifiedRR MEDICARE
VA5853559Medicaid
DC00A007P37Medicare ID - Type UnspecifiedDC MEDICARE