Provider Demographics
NPI:1609059005
Name:FERNANDEZ, MARGARET-ANNE MCGIBBON (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET-ANNE
Middle Name:MCGIBBON
Last Name:FERNANDEZ
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 1:3300 GALLOWS RD
Mailing Address - Street 2:PHYSICIAN BILLING
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3307
Mailing Address - Country:US
Mailing Address - Phone:703-776-2545
Mailing Address - Fax:703-776-2917
Practice Address - Street 1:6400 ARLINGTON BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042
Practice Address - Country:US
Practice Address - Phone:703-531-3100
Practice Address - Fax:703-531-3108
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83617208000000X
VA0101257526208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02040ZOtherMEDICARE GROUP