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Organization

FAIRFAX OB-GYN ASSOCIATES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA SHAH MD (CHIEF MEDICAL OFFICER)
(202) 899-1055
Entity
Organization

Contact information

Practice address
3650 JOSEPH SIEWICK DR, SUITE 203, FAIRFAX, VA 22033-1710
(703) 391-1500
(703) 860-1549
Mailing address
2028 OPITZ BLVD STE 1, WOODBRIDGE, VA 22191-3326
(703) 690-2295
(703) 690-6445

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2471S1302X
Sonography Radiologic Technologist
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
367A00000X
Advanced Practice Midwife

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171594
VA
Enumeration date
10/13/2007
Last updated
04/12/2019
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