Healthcare Provider Details

I. General information

NPI: 1457410656
Provider Name (Legal Business Name): NATALIE SUSAN HAUSER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD CLAUDE MOORE BLDG 2ND FLOOR
FALLS CHURCH VA
22042-3307
US

IV. Provider business mailing address

3300 GALLOWS RD BLDG STE
FALLS CHURCH VA
22042-3307
US

V. Phone/Fax

Practice location:
  • Phone: 703-776-7139
  • Fax: 703-776-7177
Mailing address:
  • Phone: 703-776-7139
  • Fax: 703-776-7117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number0101258896
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: