Pavidapha, Alex P.

Pavidapha, Alex P. is an individual health care provider with primary practice located at 1801 Robert Fulton Drive, Suite 510 , Reston VA 20191-5481. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Pavidapha, Alex P. can be contacted via phone (703) 783-5355.

Contact Information

Primary practice address
1801 Robert Fulton Drive, Suite 510 Reston VA 20191-5481
Phone: (703) 783-5355
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 0101273549 Virginia
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 287471 Massachusetts
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 287471 Massachusetts
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 0101273549 Virginia

Profile Details

NPI number 1053799585
LBN Legal business name Pavidapha, Alex P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2015
Last updated Jun 3rd, 2024 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053799585 NPPES
Virginia MEDICAID 1053799585
Virginia MEDICAID 30017438440001

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