Provider Demographics
NPI:1932133832
Name:ALFERT, JONATHAN E (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:E
Last Name:ALFERT
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 1:2722 MERRILEE DR
Mailing Address - Street 2:STE 230
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4400
Mailing Address - Country:US
Mailing Address - Phone:703-698-4483
Mailing Address - Fax:703-573-0880
Practice Address - Street 1:2722 MERRILEE DR
Practice Address - Street 2:STE 230
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4400
Practice Address - Country:US
Practice Address - Phone:703-698-4483
Practice Address - Fax:703-698-2176
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012323972085B0100X, 2085N0904X, 2085R0202X
MDD00880432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7037382OtherAETNA
MD432300900Medicaid
VA2961917OtherAETNA HMO
VA0101232397OtherLICENSE
VA0101253161Medicaid
WV1812057000Medicaid
VA235084OtherAMERIGROUP
VAP00238836OtherMEDICARE ID
DC300129817OtherMEDICARE ID
DC300129817OtherMEDICARE ID
VA2961917OtherAETNA HMO
DC300129817OtherMEDICARE ID
VA0101253161Medicaid
VAP00238836OtherMEDICARE ID