Healthcare Provider Details

I. General information

NPI: 1083811103
Provider Name (Legal Business Name): BUELENT YAPICILAR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 BOONE BLVD STE 360
VIENNA VA
22182-2632
US

IV. Provider business mailing address

8230 BOONE BLVD STE 360
VIENNA VA
22182-2632
US

V. Phone/Fax

Practice location:
  • Phone: 703-748-1000
  • Fax: 703-748-1010
Mailing address:
  • Phone: 703-748-1000
  • Fax: 703-748-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101261608
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: