1215934278 NPI number — HARVEY S SHERBER M.D.

Table of content: HARVEY S SHERBER M.D. (NPI 1215934278)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215934278 NPI number — HARVEY S SHERBER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHERBER
Provider First Name:
HARVEY
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215934278
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8505 ARLINGTON BLVD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22031-4621
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-698-8525
Provider Business Mailing Address Fax Number:
703-849-1918

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8505 ARLINGTON BLVD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22031-4621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-698-8525
Provider Business Practice Location Address Fax Number:
703-849-1918
Provider Enumeration Date:
07/06/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  0101028462 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 011552 . This is a "ANTHEM BCBS/TRIGON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6975-0003 . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 006074723 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 486321 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 502861 . This is a "NCPPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541042964 . This is a "CIGNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541042964 . This is a "KAISER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541042964 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541042964 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4091830 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541042964 . This is a "HEALTHNET/TRICARE/CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541042964 . This is a "ONE HEALTH PLAN/GREAT WST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 060005781 . This is a "MEDICARE - RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30728 . This is a "MAMSI/ALLIANCE" identifier . This identifiers is of the category "OTHER".




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