Healthcare Provider Details

I. General information

NPI: 1831164359
Provider Name (Legal Business Name): MIREN AVA SCHINCO SCHAFFER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2006
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N GEORGE MASON DR
ARLINGTON VA
22205-3683
US

IV. Provider business mailing address

1701 N GEORGE MASON DR STE 304
ARLINGTON VA
22205-3610
US

V. Phone/Fax

Practice location:
  • Phone: 703-558-5000
  • Fax:
Mailing address:
  • Phone: 202-677-6038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME78698
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101272770
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberME78698
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2015-01379
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: