Healthcare Provider Details

I. General information

NPI: 1194085027
Provider Name (Legal Business Name): FAUZIA H. ABBASI M.D, M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 05/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4080 CHAIN BRIDGE RD
FAIRFAX VA
22030-4080
US

IV. Provider business mailing address

4080 CHAIN BRIDGE RD
FAIRFAX VA
22030-4080
US

V. Phone/Fax

Practice location:
  • Phone: 703-246-4949
  • Fax: 703-352-0217
Mailing address:
  • Phone: 703-246-4949
  • Fax: 703-352-0217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number0101244411
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: