Healthcare Provider Details

I. General information

NPI: 1831149574
Provider Name (Legal Business Name): ORIN L EDDY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4375 FAIR LAKES CT
FAIRFAX VA
22033-4234
US

IV. Provider business mailing address

4375 FAIR LAKES CT
FAIRFAX VA
22033-4234
US

V. Phone/Fax

Practice location:
  • Phone: 571-432-2735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101232017
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberC55212
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: