MEDICARE: GEORGE SOPKO 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	0101044535	VA
2	207R00000X	Internal Medicine Physician	D0037566	MD

General Provider Information

NPI Number	:	1801887781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE SOPKO MD

Provider Business Mailing Address
First Line	:	6045 ARLINGTON BLVD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2721
Country	:	US
Telephone Number	:	703-237-7900
Fax Number	:	703-237-0821

Provider Business Practice Location Address
First Line	:	6045 ARLINGTON BLVD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2721
Country	:	US
Telephone Number	:	703-237-7900
Fax Number	:	703-237-0821

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	10/03/2019

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