Provider Demographics
NPI:1538129127
Name:DONALD, FELICIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:L
Last Name:DONALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21135 WHITFIELD PL
Mailing Address - Street 2:STE 101
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-7279
Mailing Address - Country:US
Mailing Address - Phone:703-488-6933
Mailing Address - Fax:703-383-9569
Practice Address - Street 1:21135 WHITFIELD PL
Practice Address - Street 2:#101
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-7279
Practice Address - Country:US
Practice Address - Phone:703-430-7779
Practice Address - Fax:703-430-9728
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040782207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA463211OtherANTHEM
VA006212701Medicaid
VAG01312Medicare PIN
E23083Medicare UPIN
VAE23083Medicare UPIN
VA00W442F01Medicare ID - Type UnspecifiedVA MEDICARE
VA006212701Medicaid