Healthcare Provider Details

I. General information

NPI: 1699080754
Provider Name (Legal Business Name): FERN L. GRAPIN, M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 08/13/2010
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 Code207VG0400X
TaxonomyGynecology Physician
License Number101039094
License Number StateVA

VIII. Authorized Official

Name: DR. FERN L GRAPIN
Title or Position: M.D.
Credential: M.D.
Phone: 703-751-3031