# FAIRFAX OB-GYN ASSOCIATES, INC.

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

## Provider details

- **NPI number:** 1891983953
- **Authorized official:** LISA SHAH MD (CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (202) 899-1055

## Contact information

- **Practice address:** 3650 JOSEPH SIEWICK DR, SUITE 203, FAIRFAX, VA 22033-1710
- **Practice address phone:** (703) 391-1500
- **Practice address fax:** (703) 860-1549
- **Mailing address:** 2028 OPITZ BLVD STE 1, WOODBRIDGE, VA 22191-3326
- **Mailing address phone:** (703) 690-2295
- **Mailing address fax:** (703) 690-6445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 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

- **Enumeration date:** 10/13/2007
- **Last updated:** 04/12/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 171594 | — | VA |