Provider Demographics
NPI:1962749374
Name:ELKINS, ANDREW DAVID (PA-C)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DAVID
Last Name:ELKINS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 75420
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-5420
Mailing Address - Country:US
Mailing Address - Phone:703-383-6469
Mailing Address - Fax:703-385-1062
Practice Address - Street 1:3620 JOSEPH SIEWICK DR
Practice Address - Street 2:STE 100
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1757
Practice Address - Country:US
Practice Address - Phone:703-810-5223
Practice Address - Fax:703-810-5403
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2020-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110004105363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
538695Medicare PIN