Healthcare Provider Details

I. General information

NPI: 1922076991
Provider Name (Legal Business Name): ELISABETH SIMMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44035 RIVERSIDE PKWY SUITE 300
LEESBURG VA
20176-5101
US

IV. Provider business mailing address

44035 RIVERSIDE PKWY SUITE 300
LEESBURG VA
20176-5101
US

V. Phone/Fax

Practice location:
  • Phone: 703-554-6800
  • Fax: 703-724-7503
Mailing address:
  • Phone: 703-554-6800
  • Fax: 703-724-7503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number0101031020
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: