Provider Demographics
NPI:1356026587
Name:FAIRFAX TMS PLLC
Entity type:Organization
Organization Name:FAIRFAX TMS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADNAN
Authorized Official - Middle Name:MAHMOOD
Authorized Official - Last Name:DURRANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-315-8210
Mailing Address - Street 1:9500 PENIWILL DR
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-3457
Mailing Address - Country:US
Mailing Address - Phone:202-315-8210
Mailing Address - Fax:
Practice Address - Street 1:9020F LORTON STATION BLVD STE 123
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4799
Practice Address - Country:US
Practice Address - Phone:571-477-0380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health