| Fairfax Internal Medicine | |
|
9844b Main St Fairfax VA 22031-3908 | |
| (703) 273-3359 | |
| (703) 273-4133 |
| Full Name | Fairfax Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 9844b Main St, Fairfax, Virginia |
| Authorized Official Name and Position | Whitney E Reese (PRESIDENT) |
| Authorized Official Contact | 7032733359 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Internal Medicine 9844b Main St Fairfax VA 22031-3908 Ph: (703) 273-3359 | Fairfax Internal Medicine 9844b Main St Fairfax VA 22031-3908 Ph: (703) 273-3359 |
| NPI Number | 1467606905 |
|---|---|
| Provider Enumeration Date | 11/11/2008 |
| Last Update Date | 06/25/2012 |
| Medicare PECOS PAC ID | 9931364015 |
|---|---|
| Medicare Enrollment ID | O20120625000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467606905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Whitney E Reese |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164458501 PECOS PAC ID: 2567627839 Enrollment ID: I20120712000136 |
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