Healthcare Provider Details

I. General information

NPI: 1952011736
Provider Name (Legal Business Name): MRS. MARGARET WILLIAMS SKOPIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS MARGARET EMILY WILLIAMS

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 INNOVATION PARK DR STE 604
FAIRFAX VA
22031-4867
US

IV. Provider business mailing address

8081 INNOVATION PARK DR STE 604
FAIRFAX VA
22031-4867
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-6880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: