Provider Demographics
NPI:1205803202
Name:FAVRET, ANNE M (MD)
Entity type:Individual
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First Name:ANNE
Middle Name:M
Last Name:FAVRET
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3040 WILLIAMS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4618
Mailing Address - Country:US
Mailing Address - Phone:571-350-8400
Mailing Address - Fax:703-280-9596
Practice Address - Street 1:8613 ROUTE 29 # 200N
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2171
Practice Address - Country:US
Practice Address - Phone:571-350-8400
Practice Address - Fax:703-280-9596
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2024-04-24
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Provider Licenses
StateLicense IDTaxonomies
VA0101051630207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA316256-266685OtherMAMSI/OP CHOICE/ALLIANCE
VA541795091OtherFIRST HEALTH
VA541795091OtherTRICARE
VA1957580004OtherCIGNA POS/PPO
VA284764OtherTRIGON/ANTHEM
VA1205803202Medicaid
VA541795091OtherFX CTY COMM HEALTH
VA500617-2174366OtherAETNA HMO
VA504732OtherNCPPO
VA541795091OtherPHCS PPO/POS
VA0870-0012OtherBCBS NCA-CARE FIRST
VA3000039OtherUNITED HEALTHCARE
VA1957580004OtherCIGNA HMO
VA223802OtherKAISER
VA500617-5801780OtherAETNA PPO
VA316256-266685OtherMAMSI/OP CHOICE/ALLIANCE
VA284764OtherTRIGON/ANTHEM
VA500617-5801780OtherAETNA PPO
VA541795091OtherTRICARE