Organization
LLFAGANMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNE LILLIAN FAGAN MD (MANAGER)
(301) 801-5886
Entity
Organization
Contact information
Practice address
1800 TOWN CENTER DR, SUITE 212, RESTON, VA 20190
(703) 435-2227
(703) 435-7856
Mailing address
4108 MARYLAND AVE, BETHESDA, MD 20816-2665
(301) 801-5886
(703) 435-7856
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/27/2006
Last updated
03/24/2018
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