Provider Demographics
NPI:1508846155
Name:FOX, EDUARDO R (MD)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:R
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6565 ARLINGTON BLVD.
Mailing Address - Street 2:STE. 210
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042
Mailing Address - Country:US
Mailing Address - Phone:703-534-1000
Mailing Address - Fax:703-536-7763
Practice Address - Street 1:6565 ARLINGTON BLVD.
Practice Address - Street 2:STE. 210
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042
Practice Address - Country:US
Practice Address - Phone:703-534-1000
Practice Address - Fax:703-534-1000
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101221516208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006731678Medicaid