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General NPI Number Information
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NPI Number | 1174724876
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Entity Type | Individual
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Provider Name | ROLLA JABER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 3700 JOSEPH SIEWICK DR SUITE 403
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City | FAIRFAX
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State | VA
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Zip | 22033-1744
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Country | US
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Telephone | 703-648-2488
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Fax | 703-648-2489
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Provider Business Mailing Address
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Address Line | 3700 JOSEPH SIEWICK DRIVE SUITE 403
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City | FAIRFAX
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State | VA
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Zip | 22033
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Country | US
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Telephone | 703-378-2672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4301082528
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0101242253
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License Number State | VA
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