Fairchild, Su

Fairchild, Su is an sole proprietor health care provider with primary practice located at 6138 Redwood Square Ctr Ste 204 , Centreville VA 20121-4264. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Adult Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Fairchild, Su can be contacted via phone (703) 229-5453.

Contact Information

Primary practice address
6138 Redwood Square Ctr Ste 204 Centreville VA 20121-4264
Phone: (703) 229-5453
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X MD069929L Pennsylvania
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 0101250992 Virginia
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 0101250992 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD069929L Pennsylvania

Profile Details

NPI number 1861488074
LBN Legal business name Fairchild, Su
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 22nd, 2005
Last updated Oct 10th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861488074 NPPES
Pennsylvania MEDICAID 001122151

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