Healthcare Provider Details

I. General information

NPI: 1245626803
Provider Name (Legal Business Name): CHRISTINE MARIE GEORGE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 11/30/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 JOSEPH SIEWICK DR
FAIRFAX VA
22033-1709
US

IV. Provider business mailing address

3060 WILLIAMS DR
FAIRFAX VA
22031-4667
US

V. Phone/Fax

Practice location:
  • Phone: 703-391-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301116973
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101265364
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: