Provider Demographics
NPI:1689642555
Name:JONAS, WAYNE B (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:B
Last Name:JONAS
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 1:6009 BEECH TREE DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2201
Mailing Address - Country:US
Mailing Address - Phone:703-299-4800
Mailing Address - Fax:
Practice Address - Street 1:6009 BEECH TREE DRIVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2201
Practice Address - Country:US
Practice Address - Phone:703-299-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038155207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine