Provider Demographics
NPI:1114095569
Name:PETER J FECANIN MD PC
Entity Type:Organization
Organization Name:PETER J FECANIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:FECANIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-207-8600
Mailing Address - Street 1:3020 HAMAKER CT
Mailing Address - Street 2:SUITE #403
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031
Mailing Address - Country:US
Mailing Address - Phone:703-207-8600
Mailing Address - Fax:703-207-9224
Practice Address - Street 1:3020 HAMAKER CT
Practice Address - Street 2:SUITE #403
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2238
Practice Address - Country:US
Practice Address - Phone:703-207-8600
Practice Address - Fax:703-207-9224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty