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General NPI Number Information
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NPI Number | 1922327196
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Entity Type | Individual
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Provider Name | MARK VICTOR SAKRAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 1485 CHAIN BRIDGE RD SUITE 203
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City | MC LEAN
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State | VA
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Zip | 22101-4501
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Country | US
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Telephone | 571-435-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 8601 LARKHAVEN TER
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City | FAIRFAX STATION
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State | VA
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Zip | 22039-3313
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Country | US
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Telephone | 571-435-3334
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Fax |
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 0101258452
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | D79256
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License Number State | MD
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