Healthcare Provider Details

I. General information

NPI: 1912357559
Provider Name (Legal Business Name): MARINA OLIVIA GUIRGUIS HANNA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARINA OLIVIA GUIRGUIS M.D.

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44045 RIVERSIDE PKWY STE 220
LEESBURG VA
20176-5101
US

IV. Provider business mailing address

44045 RIVERSIDE PKWY
LEESBURG VA
20176-5101
US

V. Phone/Fax

Practice location:
  • Phone: 703-785-8829
  • Fax: 703-858-6157
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0116029518
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number0101279126
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: