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General NPI Number Information
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NPI Number | 1043302615
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Entity Type | Individual
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Provider Name | JONATHAN EE YAGER MD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 12/22/2009
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Provider Practice Location Address
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Address Line | 3023 HAMAKER CT SUITE 100
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City | FAIRFAX
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State | VA
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Zip | 22031-5216
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Country | US
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Telephone | 703-641-9161
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Fax | 703-641-0383
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Provider Business Mailing Address
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Address Line | 3023 HAMAKER CT SUITE 100
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City | FAIRFAX
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State | VA
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Zip | 22031-5216
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Country | US
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Telephone | 703-641-9161
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Fax | 703-641-0383
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101237803
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 200300917
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License Number State | NC
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