Provider Demographics
NPI:1861653818
Name:SEDRAKYAN, GEVORG (MD)
Entity Type:Individual
Prefix:
First Name:GEVORG
Middle Name:
Last Name:SEDRAKYAN
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 1:6020 RICHMOND HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-2157
Mailing Address - Country:US
Mailing Address - Phone:571-308-6776
Mailing Address - Fax:877-991-8997
Practice Address - Street 1:6020 RICHMOND HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-2157
Practice Address - Country:US
Practice Address - Phone:571-308-6776
Practice Address - Fax:877-991-8997
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251583207R00000X
MDD82586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine