Healthcare Provider Details

I. General information

NPI: 1043228034
Provider Name (Legal Business Name): JAMES N SIPES MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 SLEEP HOLLOW RD SUITE 4C
FALLS CHURCH VA
22044
US

IV. Provider business mailing address

2946 SLEEP HOLLOW RD SUITE 4C
FALLS CHURCH VA
22044
US

V. Phone/Fax

Practice location:
  • Phone: 703-533-2012
  • Fax: 703-533-0136
Mailing address:
  • Phone: 703-533-2012
  • Fax: 703-533-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101020675
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101020675
License Number StateVA

VIII. Authorized Official

Name: JAMES N SIPES
Title or Position: PRESIDENT
Credential: MD PC
Phone: 703-533-2012