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Individual

RENEE PAYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8500 EXECUTIVE PARK AVE, SUITE 200, FAIRFAX, VA 22031-2225
(703) 698-5220
(703) 573-2351
Mailing address
8500 EXECUTIVE PARK AVE, SUITE 200, FAIRFAX, VA 22031-2225
(703) 698-5220
(703) 573-2351

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101055149
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0030
CAREFIRST NCA
DC
01
033535
VALUE OPTIONS
VA
01
149304232
TRICARE
VA
01
202928
ANTHEM
VA
01
359063
MAMSI
01
462832-000
MAGELLAN
VA
01
513447
NCPPO
VA
01
7286105
AETNA
Enumeration date
07/18/2005
Last updated
11/10/2011
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