Provider Demographics
NPI:1104194570
Name:FAIRFAX PULMONARY & CRITICAL CARE GROUP LLC
Entity Type:Organization
Organization Name:FAIRFAX PULMONARY & CRITICAL CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABU-HAMDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-208-2273
Mailing Address - Street 1:8301 ARLINGTON BLVD
Mailing Address - Street 2:SUITE T5
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2902
Mailing Address - Country:US
Mailing Address - Phone:703-208-2273
Mailing Address - Fax:
Practice Address - Street 1:8301 ARLINGTON BLVD
Practice Address - Street 2:SUITE T5
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2902
Practice Address - Country:US
Practice Address - Phone:703-208-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty