Individual
DR. GEORGIS G KEFALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 OPITZ BLVD, WOODBRIDGE, VA 22191-3311
(703) 289-1400
(703) 289-1414
Mailing address
2730-B PROSPERITY AVENUE, FAIRFAX, VA 22031-2238
(703) 289-1400
(703) 289-1414
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
0101041109
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142032
ECFMG
—
05
—
6716334
—
VA
05
—
6717560
—
VA
05
—
6718809
—
VA
Enumeration date
05/27/2006
Last updated
07/08/2007
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