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Individual

DR. ANDREW A FANOUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1500 N BEAUREGARD ST STE 300, ALEXANDRIA, VA 22311-1715
(571) 472-4100
(571) 472-4101
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101264652
VA
207T00000X
Neurological Surgery Physician
DR.0059437
CO
2084N0400X
Neurology Physician
0059437
CO

Other

Enumeration date
05/16/2011
Last updated
12/20/2022
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