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Organization
FAIRFAX OB-GYN ASSOCIATES, INC.
Active
Organization
FAIRFAX OB-GYN ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA SHAH MD (CHIEF MEDICAL OFFICER)
(202) 899-1055
Entity
Organization
Contact information
Practice address
3650 JOSEPH SIEWICK DR, SUITE 203, FAIRFAX, VA 22033-1710
(703) 391-1500
(703) 860-1549
Mailing address
2028 OPITZ BLVD STE 1, WOODBRIDGE, VA 22191-3326
(703) 690-2295
(703) 690-6445
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
2471S1302X
Sonography Radiologic Technologist
—
NULL
2471S1302X
Sonography Radiologic Technologist
—
—
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
—
NULL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
NULL
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171594
—
VA
Enumeration date
10/13/2007
Last updated
04/12/2019
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