Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 0116028437 | VA |
Y | 207QS0010X | Family Doctor - Sports Medicine | 0116028437 | VA |
NPI | 1194111641 |
---|---|
Provider Name | Stephanie Singh |
First Address | Fairfax, VA 22033-2908 |
Second Address | Fairfax, VA 22033-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2015 |
Last Update Date | 27/07/2020 |