Healthcare Provider Details

I. General information

NPI: 1407842263
Provider Name (Legal Business Name): CINDY S MARROW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 OLDE GREENWICH DR STE 300
FREDERICKSBURG VA
22408-4008
US

IV. Provider business mailing address

125 OLDE GREENWICH DR STE 300
FREDERICKSBURG VA
22408-4008
US

V. Phone/Fax

Practice location:
  • Phone: 540-374-5599
  • Fax: 540-735-8097
Mailing address:
  • Phone: 540-374-5599
  • Fax: 540-735-8097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number0101226947
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: