Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BLAKE R ZELICKSON, M.D., PH.D.
Active Sole ProprietorDR. BLAKE R ZELICKSON, M.D., PH.D. is a Dermatology healthcare provider located in STERLING, Virginia. NPI 1902292394 is currently active in the NPPES registry. Verify at CMS.
Dermatology · STERLING, VA
Registration Details
- NPI Number
- 1902292394
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 13, 2015 (11.32265354057 yrs)
- Last Updated
- Jan 5, 2026
- License
-
0101269123 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
22365 BRODERICK DRIVE, SUITE 115STERLING, VA, 201669362Browse VA providers · Browse ZIP 20166
- Phone
- 1703996400
- Fax
- 5717078123
- Primary Specialty
-
Dermatology
207N00000X
Other Dermatology Providers in STERLING, VA
| Name | Credential | NPI |
|---|---|---|
| DR. DOUGLAS SCOTT RICHARDSON | M.D. | 1073586582 |
| ANJALI D CHANDELA | M.D. | 1982652269 |
| STEPHANIE Y. DANIEL | M.D. | 1578774741 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.