MEDICARE: INTEGRATED NEUROLOGY SERVICES

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	261QM2500X	Medical Specialty Clinic/Center	0101225797	VA

General Provider Information

NPI Number	:	1699953810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED NEUROLOGY SERVICES

Provider Business Mailing Address
First Line	:	6355 WALKER LN STE 313
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-3258
Country	:	US
Telephone Number	:	703-313-9111
Fax Number	:	703-313-4945

Provider Business Practice Location Address
First Line	:	6355 WALKER LN STE 313
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-3258
Country	:	US
Telephone Number	:	703-313-9111
Fax Number	:	703-313-4945

Authorized Official
Title or Position	:	MD
Name	:	DR. SIMON FISHMAN
Credential	:
Telephone Number	:	703-313-9111

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	10/09/2025

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Directions to “INTEGRATED NEUROLOGY SERVICES ” Practice Location

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