Provider Demographics
NPI:1174516694
Name:MA, FELIX YI HO (MD)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:YI HO
Last Name:MA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6862 ELM ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3862
Mailing Address - Country:US
Mailing Address - Phone:703-992-0649
Mailing Address - Fax:703-992-6419
Practice Address - Street 1:6862 ELM ST STE 600
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3862
Practice Address - Country:US
Practice Address - Phone:703-992-0649
Practice Address - Fax:703-992-6419
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234798207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00047760OtherRR MEDICARE
VACG8678OtherRR MEDICARE GROUP PIN
VA010091373Medicaid
VA5647339Medicaid
H19260Medicare UPIN
VAC06319Medicare PIN
VA010091373Medicaid