Provider Demographics
NPI:1588144604
Name:EILAND, SETH BRADLEY (PA-C)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:BRADLEY
Last Name:EILAND
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N GLEBE RD STE 303
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3558
Mailing Address - Country:US
Mailing Address - Phone:703-841-1290
Mailing Address - Fax:703-841-1315
Practice Address - Street 1:2501 N GLEBE RD STE 303
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-3558
Practice Address - Country:US
Practice Address - Phone:703-841-1290
Practice Address - Fax:703-841-1315
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC07109363A00000X
363AM0700X
VA0110007438363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical