Provider Demographics
NPI:1700874138
Name:ADLER, OSCAR (MD, PHD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:19490 SANDRIDGE WAY, SUITE 120
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3469
Practice Address - Country:US
Practice Address - Phone:703-723-5555
Practice Address - Fax:703-562-6996
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234619207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1700874138Medicaid
VA30015815110001Medicaid
VAC10451Medicare PIN
VA1700874138Medicaid
DCG02824Medicare PIN
DC244562ZBTPMedicare PIN