Individual
LEONARD ILKHANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3300
(703) 776-4001
(703) 776-7113
Mailing address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3300
(703) 776-4001
(703) 776-7113
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101254202
VA
207RC0001X
Clinical Cardiac Electrophysiology Physician
0101254202
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06380
MEDICARE VIRGINIA PTAN
VA
01
—
G00773
MEDICARE DC PTAN
DC
Enumeration date
12/14/2006
Last updated
03/19/2021
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