Healthcare Provider Details

I. General information

NPI: 1497109714
Provider Name (Legal Business Name): SEAN EDWARD SYKES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FORT BELVOIR COMMUNITY HOSPITAL 9300 DEWITT LOOP
FORT BELVOIR VA
22060
US

IV. Provider business mailing address

WALTER REED NATIONAL MILITARY CTR 8901 WISCONSIN AVENUE
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-3224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number1676
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: