Provider Demographics
NPI:1851889158
Name:EDGAR, RICHARD JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:EDGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2445 ARMY NAVY DR FL 4
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2988
Mailing Address - Country:US
Mailing Address - Phone:703-892-6500
Mailing Address - Fax:703-769-8437
Practice Address - Street 1:1850 TOWN CENTER PKWY STE 459
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3300
Practice Address - Country:US
Practice Address - Phone:703-892-6500
Practice Address - Fax:703-769-8437
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0094921207QS0010X
PAMD473773207QS0010X
390200000X
VA0101275769207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program