Basic Information
| Provider Information | |||||||||
| NPI: | 1780047001 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FAYAD | ||||||||
| FirstName: | KATHARINE | ||||||||
| MiddleName: | MEYER | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2501 PARKERS LN | ||||||||
| Address2: | DEPARTMENT OF EMERGENCY MEDICINE | ||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 223063209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7036647112 | ||||||||
| FaxNumber: | 7036647531 | ||||||||
| Practice Location | |||||||||
| Address1: | 2501 PARKERS LANE | ||||||||
| Address2: | DEPARTMENT OF EMERGENCY MEDICINE | ||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7036647112 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2016 | ||||||||
| LastUpdateDate: | 08/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 0101267160 | VA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.