Healthcare Provider Details

I. General information

NPI: 1407974769
Provider Name (Legal Business Name): WILLIAM SAWCHUK MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 05/01/2020
Certification Date: 05/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8320 OLD COURTHOUSE RD STE 303
VIENNA VA
22182-3883
US

IV. Provider business mailing address

8320 OLD COURTHOUSE RD STE 303
VIENNA VA
22182-3883
US

V. Phone/Fax

Practice location:
  • Phone: 703-532-7211
  • Fax: 703-534-2874
Mailing address:
  • Phone: 703-532-7211
  • Fax: 703-534-2874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM SAMUEL SAWCHUK
Title or Position: PRESIDENT
Credential: MD
Phone: 703-532-7211