Healthcare Provider Details

I. General information

NPI: 1528513868
Provider Name (Legal Business Name): FAUQUIER CRITICAL CARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HOSPITAL DR
WARRENTON VA
20186-3027
US

IV. Provider business mailing address

500 HOSPITAL DR
WARRENTON VA
20186-3027
US

V. Phone/Fax

Practice location:
  • Phone: 703-631-1745
  • Fax: 703-552-2743
Mailing address:
  • Phone: 703-631-1745
  • Fax: 703-552-2743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MALIHA GILLANI
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 703-631-1745