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Individual

IVAN AKSENTIJEVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4660 KENMORE AVE STE 1018, ALEXANDRIA, VA 22304-1306
(571) 483-1800
(703) 823-5723
Mailing address
3040 WILLIAMS DR, SUITE 100, FAIRFAX, VA 22031-4618
(703) 208-3963
(703) 205-6284

Taxonomy

Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
0101234651
VA
207RH0003X
Hematology & Oncology Physician
Primary
0101234651
VA
207RX0202X
Medical Oncology Physician
0101234651
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08700018
BCBS NCA CARE FIRST
VA
05
1982672937
VA
01
2311042
UNITED HEALTHCARE
VA
01
316256-2107058
MAMSI/ OP CHOICE/ALLIANCE
VA
01
3212244
AETNA HMO
VA
01
386769
ANTHEM/TRIGON
VA
01
541795091
CHOICE CARE
VA
01
541795091-2067228
FIRST HEALTH
VA
01
560987
NCPPO
VA
01
6252107
CIGNA HMO/POS/PPO
VA
01
7501495
AETNA PPO
VA
Enumeration date
03/08/2006
Last updated
11/11/2025
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