Healthcare Provider Details

I. General information

NPI: 1659830529
Provider Name (Legal Business Name): ALEXANDER UPFILL-BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 SUNRISE VALLEY DR FL 8
RESTON VA
20191-5300
US

IV. Provider business mailing address

11800 SUNRISE VALLEY DR FL 8
RESTON VA
20191-5300
US

V. Phone/Fax

Practice location:
  • Phone: 703-709-1114
  • Fax:
Mailing address:
  • Phone: 703-709-1114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number0101289172
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: