Individual
ARA ANTHONY AVEDISIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
346 MAPLE AVE. WEST, VIENNA, VA 22180
(703) 242-1415
Mailing address
346 MAPLE AVE. WEST, VIENNA, VA 22180
(703) 242-1415
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC006248L
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015392
ANTHEM PROVIDER NUMBER
VA
01
—
G665-0001
CAREFIRST PROVIDER NUMBER
VA
Enumeration date
10/02/2006
Last updated
07/08/2007
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