# INOVA FAIRFAX HOSPITAL

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

## Provider details

- **NPI number:** 1619133295
- **Authorized official:** DR. DANIEL BRUEGGEMANN (HOUSESTAFF)
- **Authorized official phone:** (804) 475-9165

## Contact information

- **Practice address:** 3650 JOSEPH SIEWICK DR, SUITE 4TH FLOOR, FAIRFAX, VA 22033-1710
- **Practice address phone:** (703) 391-2020
- **Mailing address:** PO BOX 791128, BALTIMORE, MD 21279-1128
- **Mailing address phone:** (703) 391-2020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 08/01/2008
- **Last updated:** 08/01/2008