Provider Demographics
NPI:1851570899
Name:TRAHOS, MICHAEL C (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:TRAHOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 OSAGE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-2607
Mailing Address - Country:US
Mailing Address - Phone:703-998-4913
Mailing Address - Fax:703-931-8171
Practice Address - Street 1:1707 OSAGE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-2607
Practice Address - Country:US
Practice Address - Phone:703-998-4913
Practice Address - Fax:703-931-8171
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102035626207Q00000X, 207QA0505X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4088139OtherAETNA
VA182247OtherANTHEM BC/BS
VA280953OtherUNITED HEALTHCARE PPO
VADD8984OtherRAILROAD MEDICARE
VA010201021Medicaid
VA8138371OtherMDIPA/OPTIMUM CHOICE HMO
VA1122318OtherFIRST HEALTH NETWORK
VA503495OtherUNICARE PPO
VA2138371OtherONE NET PPO/UNITED HEALTHCARE
VA976064OtherMAILHANDLERS PPO
DC8857-0001OtherCAREFIRST BC/BS OF NATIONAL CAPITAL AREA
VA1433740OtherCIGNA
VA144441OtherSOUTHERN HEALTH SERV. INC
VA470178OtherAETNA HMO
DC8857-0001OtherCAREFIRST BC/BS OF NATIONAL CAPITAL AREA
D84002Medicare UPIN
DCG02178Medicare PIN