Provider Demographics
NPI:1750564589
Name:FARTASH, SIMA (MD)
Entity type:Individual
Prefix:
First Name:SIMA
Middle Name:
Last Name:FARTASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:821 S KING ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3921
Mailing Address - Country:US
Mailing Address - Phone:703-669-0005
Mailing Address - Fax:703-669-0015
Practice Address - Street 1:821 S KING ST
Practice Address - Street 2:SUITE E
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3921
Practice Address - Country:US
Practice Address - Phone:703-669-0005
Practice Address - Fax:703-669-0015
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-16
Last Update Date:2012-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101242784207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine