Provider Demographics
NPI:1831112705
Name:SARRIS, GEORGE A (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:SARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GEORGE
Other - Middle Name:ALEXANDER
Other - Last Name:SARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3920A BRIDGE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-1117
Mailing Address - Country:US
Mailing Address - Phone:757-983-0330
Mailing Address - Fax:757-431-7788
Practice Address - Street 1:3920A BRIDGE RD STE 202
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-1117
Practice Address - Country:US
Practice Address - Phone:757-983-0330
Practice Address - Fax:757-431-7788
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231293207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5859557Medicaid
VA5859557Medicaid
VAG65288Medicare UPIN
VAC10680Medicare PIN
VAC01491Medicare ID - Type UnspecifiedMEDICARE GROUP ID #