Healthcare Provider Details

I. General information

NPI: 1720911522
Provider Name (Legal Business Name): DARWIN LUKE MACH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12099 GOVERNMENT CENTER PKWY
FAIRFAX VA
22035-5501
US

IV. Provider business mailing address

12300 ROUTE 50
FAIRFAX VA
22033-2810
US

V. Phone/Fax

Practice location:
  • Phone: 703-246-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberB202504875
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: