| Family Healthcare Of Fairfax Pc | |
|
3025 Hamaker Ct Ste 350 Fairfax VA 22031-2243 | |
| (703) 573-6400 | |
| (703) 641-5821 |
| Full Name | Family Healthcare Of Fairfax Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3025 Hamaker Ct Ste 350, Fairfax, Virginia |
| Authorized Official Name and Position | Eugene A Shmorhun (OWNER) |
| Authorized Official Contact | 7035736400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Healthcare Of Fairfax Pc 3025 Hamaker Ct Ste 350 Fairfax VA 22031-2243 Ph: (703) 573-6400 | Family Healthcare Of Fairfax Pc 3025 Hamaker Ct Ste 350 Fairfax VA 22031-2243 Ph: (703) 573-6400 |
| NPI Number | 1144357633 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 12/05/2012 |
| Medicare PECOS PAC ID | 8921286717 |
|---|---|
| Medicare Enrollment ID | O20110627000234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144357633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Eugene A Shmorhun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255468526 PECOS PAC ID: 8729246517 Enrollment ID: I20120224000612 |
| Provider Name | Catherine Tong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801192711 PECOS PAC ID: 4082837166 Enrollment ID: I20140516001532 |
| Provider Name | David Dewitte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780666388 PECOS PAC ID: 0648365262 Enrollment ID: I20230119000056 |
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