Individual
KANIZ FATEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12581 MILSTEAD WAY STE 103, WOODBRIDGE, VA 22192-5446
(703) 437-6060
Mailing address
9527 PARSONAGE LN, LORTON, VA 22079-2776
(703) 646-5494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101241486
VA
261QU0200X
Urgent Care Clinic/Center
0101241486
VA
Other
Enumeration date
07/02/2007
Last updated
11/05/2018
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