NPI 1073700845

Fairfax Urology Associates LTD

Organisation Urology Physician Fairfax, VA

Practice location

Address: 10875 Main St Suite 208, Fairfax, VA 22030-4732
Phone: (703) 591-5443
Fax: (703) 591-0486

Authorised official

Name: William Lloyd Glover
Title: Ceo Owner
Phone: (703) 591-5443

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 0101022555 (VA)

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Registry record

NPI: 1073700845
Entity type: Organization
NPI issued: 26 Sep 2007
Record last updated: 10 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.