INTEGRATED DERMATOLOGY OF FAIRFAX, LLC (NPI# 1861890303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861890303 |
| Entity Type | Organization |
| Organization Name | INTEGRATED DERMATOLOGY OF FAIRFAX, LLC |
| Practice Address |
10721 Main St Ste 200 Fairfax VA 22030-6913 |
| Mailing Address |
4700 Exchange Ct Ste 110 Boca Raton FL 33431-4450 |
| Practice Telephone | 7033522620 |
| Practice Fax Number | 7033522594 |
| Mailing Telephone | 5613142000 |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2019-01-16 |
| Authorized Official Name | JEFFREY D. QUEEN (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 5613142000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
10721 MAIN ST STE 200 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-6913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518396951 | Samantha Hancock | Physician Assistant | 10721 Main St Ste 200, Fairfax, VA 22030-6913 | 2013-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 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 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174901953 | Amanda Unalivia | Dermatology | 3700 Joseph Siewick Dr Ste 302, Fairfax, VA 22033-1739 | 2015-05-12 |
| 1134516271 | Kathleen Ellison | Dermatology | 8316 Arlington Blvd Ste 400, Fairfax, VA 22031-5216 | 2015-04-15 |
| 1508276619 | Charles Martin Aaronson | Dermatology | 3606 Lido Pl., Fairfax, VA 22031 | 2014-04-29 |
| 1740359017 | Moses K Albert | Dermatology | 3025 Hamaker Ct Ste 300, Fairfax, VA 22031-2237 | 2006-11-08 |
| 1205212933 | Dermatology of Virginia | Dermatology | 3930 Pender Dr, Suite 210, Fairfax, VA 22030-0985 | 2015-08-04 |
| 1497173512 | Michele Zerah Magnino | Dermatology | 3025 Hamaker Ct Ste 300, Fairfax, VA 22031-2237 | 2014-04-05 |
| 1457796641 | Renascance Dermatology PC | Dermatology | 3620 Joseph Siewick Dr, Suite 303, Fairfax, VA 22033-1756 | 2013-05-01 |
| 1093158461 | Monica Nabil Saleh Valentin | Dermatology | 11351 Random Hills Rd, Fairfax, VA 22030 | 2013-04-16 |
| 1245404276 | Carol L Piatt, Md, PC | Dermatology | 8301 Arlington Blvd, Suite 501, Fairfax, VA 22031-2902 | 2008-04-22 |
| 1255501417 | Moses K Albert Md PC | Dermatology | 3020 Hamaker Ct, Fairfax, VA 22031-2238 | 2008-03-04 |
| Find all providers in FAIRFAX | ||||
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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.