Healthcare Provider Details

I. General information

NPI: 1336839059
Provider Name (Legal Business Name): SAXENA MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8250 SANCTUARY DR
COLUMBUS OH
43235-4639
US

IV. Provider business mailing address

11166 FAIRFAX BLVD STE 500
FAIRFAX VA
22030-5017
US

V. Phone/Fax

Practice location:
  • Phone: 703-508-4421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SUNIL SAXENA
Title or Position: MD
Credential:
Phone: 703-508-4421