Healthcare Provider Details

I. General information

NPI: 1073825592
Provider Name (Legal Business Name): KAMILAH MILLER HALMON M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042
US

IV. Provider business mailing address

8190 STRAWBERRY LANE APT 302
FALLS CHURCH VA
22042-1037
US

V. Phone/Fax

Practice location:
  • Phone: 703-776-7834
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0116022358
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101253580
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: