Healthcare Provider Details

I. General information

NPI: 1831267426
Provider Name (Legal Business Name): PAULA NOFFSINGER FERGUSSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS PAULA ANNE NOFFSINGER

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46165 WESTLAKE DR SUITE 210
POTOMAC FALLS VA
20165
US

IV. Provider business mailing address

46165 WESTLAKE DR SUITE 210
POTOMAC FALLS VA
20165
US

V. Phone/Fax

Practice location:
  • Phone: 703-433-1555
  • Fax: 703-444-9830
Mailing address:
  • Phone: 703-433-1555
  • Fax: 703-444-9830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101042351
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: