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Individual

DR. SIMON FISHMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6355 WALKER LANE, 313, ALEXANDRIA, VA 22310
(703) 313-9111
(703) 313-4945
Mailing address
6355 WALKER LANE, 313, ALEXANDRIA, VA 22310
(703) 313-9111
(703) 313-4945

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101225797
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010045479
VA
01
102355
ANTHEM
VA
01
2119441
ALLIANCE/ MAMSI
VA
01
267731
AMERIGROUP
VA
01
3403215
AETNA HMO
VA
01
518960
NCPPO
VA
01
7099103
AETNA PPO
VA
01
J330 0001
CF BC BS DC
DC
01
P00148017
RAILROAD MEDICARE
VA
Enumeration date
09/28/2006
Last updated
12/21/2015
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