Healthcare Provider Details

I. General information

NPI: 1609059005
Provider Name (Legal Business Name): MARGARET-ANNE MCGIBBON FERNANDEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 ARLINGTON BLVD. SUITE 200
FALLS CHURCH VA
22042
US

IV. Provider business mailing address

3300 GALLOWS RD PHYSICIAN BILLING
FALLS CHURCH VA
22042-3307
US

V. Phone/Fax

Practice location:
  • Phone: 703-531-3100
  • Fax: 703-531-3108
Mailing address:
  • Phone: 703-776-2545
  • Fax: 703-776-2917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA83617
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101257526
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: