Provider Demographics
NPI:1457694630
Name:VLACANCICH, RAYMOND HENRY (DO)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:HENRY
Last Name:VLACANCICH
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2901 TELESTAR CT STE 300
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1263
Mailing Address - Country:US
Mailing Address - Phone:703-591-1688
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:1005 N GLEBE RD STE 750
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5766
Practice Address - Country:US
Practice Address - Phone:703-524-7202
Practice Address - Fax:703-516-4501
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2023-07-14
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Provider Licenses
StateLicense IDTaxonomies
VA0102204410207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology