Individual
NAMIK ERDAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8629 SUDLEY RD, SUITE 102, MANASSAS, VA 20110-4590
(703) 361-3030
Mailing address
PO BOX 1067, MANASSAS, VA 20108-1067
(703) 361-3030
(703) 361-3030
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101238318
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010175445
—
VA
05
—
010175488
—
VA
05
—
010175500
—
VA
05
—
010177502
—
VA
05
—
010177529
—
VA
01
—
208822489
TRICARE
VA
01
—
6688-0032
CAREFIRST
VA
Enumeration date
01/18/2006
Last updated
11/04/2011
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