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General NPI Number Information
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NPI Number | 1063377315
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Entity Type | Organization
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Legal Business Name | EMERGENCY MEDICINE ASSOCIATES P.A., P.C.
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 4315 CHAIN BRIDGE RD
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City | FAIRFAX
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State | VA
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Zip | 22030-3061
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Country | US
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Telephone | 703-877-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 4535 DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-2545
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Country | US
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Telephone | 330-493-4443
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT COORDINATOR
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Name | JENNIFER CHASTAIN
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Credential |
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Telephone | 330-994-4430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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