Organization
FAIRFAX COLON & RECTAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DELAC CMPE (ADMINISTRATOR)
(703) 650-2333
Entity
Organization
Contact information
Practice address
2710 PROPERSITY AVE, STE 200, FAIRFAX, VA 22031
(703) 280-2841
(703) 650-2322
Mailing address
2710 PROPERSITY AVE, STE 200, FAIRFAX, VA 22031
(703) 280-2841
(703) 650-2322
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
Other
Enumeration date
08/31/2006
Last updated
12/06/2013
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