Organization
FAIRFAX MEDICAL ASSOCIATES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESAM AL NOUMAN LSA (PRESIDENT)
(214) 227-2457
Entity
Organization
Contact information
Practice address
12011 LEE JACKSON MEMORIAL HWY STE 501, FAIRFAX, VA 22033-3315
(703) 259-7027
Mailing address
PO BOX 45718, BALTIMORE, MD 21297-5718
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
VA
Other
Enumeration date
07/25/2017
Last updated
08/14/2023
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