Healthcare Provider Details

I. General information

NPI: 1750214441
Provider Name (Legal Business Name): RAZAN FADL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 FISHER ST APT 310
CHARLOTTESVILLE VA
22911-3669
US

IV. Provider business mailing address

325 FISHER ST APT 310
CHARLOTTESVILLE VA
22911-3669
US

V. Phone/Fax

Practice location:
  • Phone: 804-819-9949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202204782
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: