MEDICARE: JOHN P ESSEPIAN MD PC

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	207W00000X	Ophthalmology Physician		VA

General Provider Information

NPI Number	:	1902085376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN P ESSEPIAN MD PC

Provider Business Mailing Address
First Line	:	9936 MAIN ST
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-3901
Country	:	US
Telephone Number	:	703-591-4884
Fax Number	:	703-591-6932

Provider Business Practice Location Address
First Line	:	9936 MAIN ST
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-3901
Country	:	US
Telephone Number	:	703-591-4884
Fax Number	:	703-591-6932

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	DR. JOHN PHILLIP ESSEPIAN
Credential	:
Telephone Number	:	703-591-4884

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	02/18/2010

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