Individual
CHARLES RAYMOND FENCIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3650 JOSEPH SIEWICK DR STE 400, FAIRFAX, VA 22033-1715
(703) 391-2020
Mailing address
3650 JOSEPH SIEWICK DR STE 400, FAIRFAX, VA 22033-1715
(703) 391-2020
(703) 391-1211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101273412
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116033954
VA
Other
Enumeration date
06/16/2020
Last updated
04/17/2026
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