Healthcare Provider Details

I. General information

NPI: 1275850430
Provider Name (Legal Business Name): ELVIS XHAFERI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2010
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 WELLFORD ST STE 100
FREDERICKSBURG VA
22401
US

IV. Provider business mailing address

2800 WELLFORD ST
FREDERICKSBURG VA
22401-3176
US

V. Phone/Fax

Practice location:
  • Phone: 154-036-1183
  • Fax:
Mailing address:
  • Phone: 405-361-1830
  • Fax: 540-361-4968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number2015-00986
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: