Provider Demographics
NPI:1588672349
Name:HOARE, RAYMOND R (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:R
Last Name:HOARE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3022 WILLIAMS DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031
Mailing Address - Country:US
Mailing Address - Phone:703-573-9800
Mailing Address - Fax:703-573-2959
Practice Address - Street 1:3833 N FAIRFAX DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203
Practice Address - Country:US
Practice Address - Phone:703-525-8863
Practice Address - Fax:703-525-2387
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2014-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101019085207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00311447OtherRR MEDICARE
VA010171865Medicaid
P00311447OtherRR MEDICARE
011560G45Medicare PIN