Healthcare Provider Details

I. General information

NPI: 1194351098
Provider Name (Legal Business Name): CELINE FADEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E LEIGH ST
RICHMOND VA
23298-5004
US

IV. Provider business mailing address

7202 GLEN FOREST DR STE 200
RICHMOND VA
23226-3780
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-7999
  • Fax: 804-828-5941
Mailing address:
  • Phone: 804-391-4171
  • Fax: 804-200-6229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0102207916
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0102207916
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: