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NPI Code Detail

MEDICARE: SARA LINDSAY GILLAM P.A.

MEDICARE: SARA LINDSAY GILLAM P.A.
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
1363AM0700XMedical Physician AssistantC0003485MD
2363AM0700XMedical Physician Assistant0110003987VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598947111
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA LINDSAY GILLAM P.A.
Provider Business Mailing Address
First Line : 2901 TELESTAR CT STE 300
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22042-1263
Country : US
Telephone Number : 703-591-1688
Fax Number : 703-591-1445
Provider Business Practice Location Address
First Line : 2901 TELESTAR CT STE 100
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22042-1261
Country : US
Telephone Number : 703-208-9797
Fax Number : 703-591-0829
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2007
Last Update Date : 07/21/2023

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Directions to “ SARA LINDSAY GILLAM P.A.” Practice Location

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