Healthcare Provider Details

I. General information

NPI: 1093178097
Provider Name (Legal Business Name): KIMBERLY FABYAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE WALTER REED NATIONAL MILITARY MEDICAL CENTER - IM
BETHESDA MD
20889-0004
US

IV. Provider business mailing address

8901 WISCONSIN AVE WALTER REED NATIONAL MILITARY MEDICAL CENTER - IM
BETHESDA MD
20889-0004
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-0451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101264616
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101264616
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101264616
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: