Individual
ANDREW AXELRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11440 COMMERCE PARK DR, LL4, RESTON, VA 20191-1555
(703) 766-2650
(703) 766-2654
Mailing address
1939 ROLAND CLARKE PL, STE 200, RESTON, VA 20191-1445
(703) 435-3366
(703) 435-8022
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
472345
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016048480
—
VA
Enumeration date
04/21/2006
Last updated
03/09/2020
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