# DULLES PAIN & FUNCTIONAL MEDICINE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518573534
- **Authorized official:** ISSAM KHAYATA MD (OWNER)
- **Authorized official phone:** (703) 884-8400

## Contact information

- **Practice address:** 20 PIDGEON HILL DR STE 205, STERLING, VA 20165-6134
- **Practice address phone:** (703) 884-8400
- **Mailing address:** PO BOX 2521, RESTON, VA 20195-0521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2020
- **Last updated:** 10/14/2020