Organization
FAIRFAX RADIOLOGICAL CONSULTANTS PC
Active
Parent organization
FAIRFAX RADIOLOGICAL CONSULTANTS PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRFAX RADIOLOGICAL CONSULTANTS PC
Authorized official
BILL F ALLISON (EXECUTIVE DIRECTOR)
(703) 698-4483
Entity
Organization
Contact information
Practice address
100 ELDEN ST, STE 16, HERNDON, VA 20170-4873
(703) 698-4483
(703) 573-0880
Mailing address
2722 MERRILEE DR, SUITE 230, FAIRFAX, VA 22031-4400
(703) 698-4483
(703) 573-0880
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089044
ANTHEM BCBS
VA
Enumeration date
01/10/2008
Last updated
05/15/2008
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