Provider Demographics
NPI:1922327196
Name:SAKRAN, MARK VICTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:VICTOR
Last Name:SAKRAN
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 1:8601 LARKHAVEN TER
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-3313
Mailing Address - Country:US
Mailing Address - Phone:571-435-3334
Mailing Address - Fax:
Practice Address - Street 1:1485 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4501
Practice Address - Country:US
Practice Address - Phone:571-435-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012584522084P0804X
MDD792562084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry