Healthcare Provider Details

I. General information

NPI: 1043403397
Provider Name (Legal Business Name): ANEZ & BITAR MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8365A GREENSBORO DR
MC LEAN VA
22102-3530
US

IV. Provider business mailing address

8365A GREENSBORO DR
MC LEAN VA
22102-3530
US

V. Phone/Fax

Practice location:
  • Phone: 703-356-4444
  • Fax: 703-734-0129
Mailing address:
  • Phone: 703-356-4444
  • Fax: 703-734-0129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101035273
License Number StateVA

VIII. Authorized Official

Name: DR. YASMIN K. ANEZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-356-4444