Healthcare Provider Details

I. General information

NPI: 1376832956
Provider Name (Legal Business Name): REBECCA WITT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS ROAD DEPARTMENT OF MEDICINE
FALLS CHURCH VA
22042
US

IV. Provider business mailing address

3300 GALLOWS ROAD DEPARTMENT OF MEDICINE
FALLS CHURCH VA
22042
US

V. Phone/Fax

Practice location:
  • Phone: 703-776-3582
  • Fax:
Mailing address:
  • Phone: 703-776-3582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101255942
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number1010255942
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: