GEORGE MASON UNIVERSITY STUDENT HEALTH SERVICE (NPI# 1336588367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336588367 |
| Entity Type | Organization |
| Organization Name | GEORGE MASON UNIVERSITY STUDENT HEALTH SERVICE |
| Practice Address |
4400 University Dr Ms 2 D3 Fairfax VA 22030-4422 |
| Practice Telephone | 7039932831 |
| Practice Fax Number | 7039934365 |
| Mailing Telephone | 7039932831 |
| Mailing Fax Number | 7039934365 |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2013-06-24 |
| Authorized Official Name | WAGIDA ABDALLA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7039932831 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities |
| Street Address |
4400 UNIVERSITY DR MS 2 D3 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-4422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245210079 | Mary E. Davis | Nurse Practitioner | 4400 University Dr, Ms 2d3, Fairfax, VA 22030-4422 | 2006-01-18 |
| 1326685207 | Yusufu Kamara | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-10 |
| 1861039752 | Kathy Nguyen | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-10 |
| 1093352007 | Phung Kim Pham | Specialist/Technologist | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-09 |
| 1083251169 | Hailey Arnold | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4444 | 2019-12-08 |
| 1376180471 | Latoya Marie Lashley | Specialist/Technologist | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-08 |
| 1609413715 | Claudia Talton | Specialist/Technologist | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-08 |
| 1063059152 | Ali Ahmad | Specialist/Technologist | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-08 |
| 1386281467 | Archana Bai Reddy | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-07 |
| 1861039331 | Janet Rae Stein | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-04 |
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|---|---|---|---|---|
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| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
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| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
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| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720640790 | Samon Nazemian | Clinic/Center | 3700 Joseph Siewick Dr, Fairfax, VA 22033-1744 | 2019-07-01 |
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| 1992201891 | Moses Kwasi Lopez-twumasi | Clinic/Center | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2018-04-01 |
| 1083015960 | Southern Virginia University | Clinic/Center | 1 University Hill Dr, Knight Sports Arena, Buena Vista, VA 24416-3038 | 2014-09-10 |
| 1942540208 | Washington and Lee University | Clinic/Center | 204 W Washington St, Student Health Center/davis Residence Hall, Lexington, VA 24450-2116 | 2013-02-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.