Healthcare Provider Details

I. General information

NPI: 1659593952
Provider Name (Legal Business Name): MEGHAN FLEMING HULVER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11102 HOLLYBROOK CT
OAKTON VA
22124-1027
US

IV. Provider business mailing address

11102 HOLLYBROOK CT
OAKTON VA
22124-1027
US

V. Phone/Fax

Practice location:
  • Phone: 703-407-6908
  • Fax:
Mailing address:
  • Phone: 703-407-6908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number0101241512
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: