Individual
IRA SANDERS YOUNG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8503 ARLINGTON BLVD, #310, FAIRFAX, VA 22031-4628
(703) 208-4200
(703) 876-1799
Mailing address
8503 ARLINGTON BLVD, #310, FAIRFAX, VA 22031-4628
(703) 208-4200
(703) 876-1799
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101017574
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217801
ANTHEM MAIN OFFICE
—
01
—
291701
ANTHEM SATELLITE OFFICE
—
01
—
4495166
AETNA
—
01
—
502652
NCPPO
—
01
—
B131/0007
CAREFIRST BCBS
—
Enumeration date
08/10/2005
Last updated
07/08/2007
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