MEDICARE: EMILY ELIZABETH PAGAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101229769	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023001443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ELIZABETH PAGAN MD

Provider Business Mailing Address
First Line	:	5275 LEE HWY STE 200
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-1619
Country	:	US
Telephone Number	:	703-717-4090
Fax Number	:	703-717-4091

Provider Business Practice Location Address
First Line	:	5275 LEE HWY STE 200
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-1619
Country	:	US
Telephone Number	:	703-717-4090
Fax Number	:	703-717-4091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	05/09/2018

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