Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174V00000X | Clinical Ethicist | ||
Y | 207R00000X | Internist | 0101222128 | VA |
Y | 111NI0900X | Internist | 0101222128 | VA |
N | 207RG0300X | Geriatric Medicine | 0101222128 | VA |
NPI | 1750594503 |
---|---|
Provider Name | Ellen Fox |
First Address | Arlington, VA 22213-1013 |
Second Address | Arlington, VA 22213-1013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 18/02/2015 |