Healthcare Provider Details

I. General information

NPI: 1538179593
Provider Name (Legal Business Name): FERN LORRAINE GRAPIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2871 DUKE ST
ALEXANDRIA VA
22314-4512
US

IV. Provider business mailing address

2871 DUKE ST
ALEXANDRIA VA
22314-4512
US

V. Phone/Fax

Practice location:
  • Phone: 703-751-3031
  • Fax: 703-370-9016
Mailing address:
  • Phone: 703-751-3031
  • Fax: 703-370-9016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101039094
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: