Individual
ANDREW WILLIAM BAZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3650 JOSEPH SIEWICK DR, SUITE 400, FAIRFAX, VA 22033-1710
(703) 391-2020
(703) 391-1211
Mailing address
PO BOX 791128, BALTIMORE, MD 21279-1128
(703) 391-2020
(703) 391-1211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101238694
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010208360
—
VA
Enumeration date
10/10/2005
Last updated
11/27/2023
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