Provider Demographics
NPI:1982684478
Name:SAWYER, REBECCA B (MD)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:B
Last Name:SAWYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:G
Other - Last Name:BRAWLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:410 MAPLE AVENUE WEST
Mailing Address - Street 2:STE. 5
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180
Mailing Address - Country:US
Mailing Address - Phone:703-938-2244
Mailing Address - Fax:703-938-3669
Practice Address - Street 1:410 MAPLE AVENUE WEST
Practice Address - Street 2:STE. 5
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180
Practice Address - Country:US
Practice Address - Phone:703-938-2244
Practice Address - Fax:703-938-3669
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048633208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006732241Medicaid
G06365Medicare UPIN