NPI 1457796641

Renascance Dermatology PC

Organisation Dermatology Physician Fairfax, VA

Practice location

Address: 3620 Joseph Siewick Dr Suite 303, Fairfax, VA 22033-1756
Phone: (703) 865-6783
Fax: (703) 865-6784

Authorised official

Name: Dwana Rashad Shabazz
Title: Owner
Phone: (703) 865-6783

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 0101240235 (VA)

Other Dermatology providers in Virginia →

Registry record

NPI: 1457796641
Entity type: Organization
NPI issued: 1 May 2013
Record last updated: 1 May 2013

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.