Individual
DR. FETNAT FAYE MASRI-IMADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2199 OLD BRIDGE RD, LAKE RIDGE, VA 22192-2911
(703) 357-9707
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101240887
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922158716
NPI
VA
01
—
298333
BC/BS
VA
05
—
298333
—
VA
01
—
9418295
CIGNA
VA
Enumeration date
01/12/2007
Last updated
05/12/2020
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