Individual
MS. KRISTIN DERMODY MAGGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3700 JOSEPH SIEWICK DR, SUITE 308, FAIRFAX, VA 22033-1744
(703) 698-8960
(703) 716-8703
Mailing address
3700 JOSEPH SIEWICK DR, SUITE 308, FAIRFAX, VA 22033-1744
(703) 698-8960
(703) 716-8703
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0010-02818
NC
363AM0700X
Medical Physician Assistant
Primary
0110003427
VA
363AM0700X
Medical Physician Assistant
MA056117
PA
Other
Enumeration date
10/20/2010
Last updated
06/30/2015
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