MEDICARE: DODD A SIMS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0101038074	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110236764	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	F660-0001	OTHER	VA	CAREFIRST BC/BS
3	B744-0028	OTHER	VA	BCBS

General Provider Information

NPI Number	:	1124006788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DODD A SIMS MD

Provider Business Mailing Address
First Line	:	1500 N BEAUREGARD ST
Second Line	:	STE 110
City	:	ALEXANDRIA
State	:	VA
Zip	:	22311-1715
Country	:	US
Telephone Number	:	703-370-9003
Fax Number	:	703-370-2849

Provider Business Practice Location Address
First Line	:	4660 KENMORE AVE STE 710
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1306
Country	:	US
Telephone Number	:	703-370-9002
Fax Number	:	703-370-2849

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	12/17/2021

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Directions to “ DODD A SIMS MD” Practice Location

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