Healthcare Provider Details

I. General information

NPI: 1124047337
Provider Name (Legal Business Name): DAVID ANTHONY SAYLES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 12/05/2020
Certification Date: 12/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 STEVENSON AVE STE 208
ALEXANDRIA VA
22304-3526
US

IV. Provider business mailing address

6000 STEVENSON AVE STE 208
ALEXANDRIA VA
22304-3526
US

V. Phone/Fax

Practice location:
  • Phone: 703-379-7215
  • Fax: 202-265-7804
Mailing address:
  • Phone: 703-379-7215
  • Fax: 202-265-7804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number0101057479
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: