Fairfax Internal Medicine and Primary Care PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101250312 Issued in VA

Legal business name

FAIRFAX INTERNAL MEDICINE AND PRIMARY CARE PC

Practice address

5618 Ox Rd
Suite D-2
Fairfax Station, VA 22039

Phone

(703) 291-0405

Fax

(703) 337-0377

NPI assigned

Sep 14, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Karuna Galla, M.D

Title

Physician

Phone

(703) 291-0405

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1831647239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5618 OX RD",
            "address_2": "SUITE D-2",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "22039",
            "telephone_number": "703-291-0405",
            "fax_number": "703-337-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5618 OX RD",
            "address_2": "SUITE D-2",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "22039",
            "telephone_number": "703-291-0405",
            "fax_number": "703-337-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX INTERNAL MEDICINE AND PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "GALLA",
        "authorized_official_first_name": "KARUNA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "703-291-0405",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101250312",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Michelle Durkovic, MS
• Lisa Anne Eidelkind, LCSW
• Fereshteh Ejtemai, PHARMACIST
• Donna Esmaeili
• Essential Home Care LLC
• Fairfax Station Pharmacy
• Janice Irene Falk, LCSW
• Forbes Wellness LLC
• Jill Forbes, C.N.P.
• Valthea Courtney Fry, FNP-C

• Internal Medicine Physician in Fairfax Station, VA
• Providers in Fairfax Station, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.