Provider Demographics
NPI:1700870755
Name:ANDREW, JOHN ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALAN
Last Name:ANDREW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:224D CORNWALL ST NW STE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6001
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:224D CORNWALL ST NW STE 301
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-2704
Practice Address - Country:US
Practice Address - Phone:703-777-1146
Practice Address - Fax:703-777-3144
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2020-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101036900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA05841739Medicaid
110204542OtherRR MEDICARE
VA110007707Medicare PIN
VA05841739Medicaid