Provider Demographics
NPI:1750390985
Name:PEASE, ALISON FAST (MD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:FAST
Last Name:PEASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:SCOTT
Other - Last Name:FAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1715 N GEORGE MASON DRIVE
Mailing Address - Street 2:SUITE #205
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3648
Mailing Address - Country:US
Mailing Address - Phone:703-522-7300
Mailing Address - Fax:703-522-0495
Practice Address - Street 1:1715 N GEORGE MASON DRIVE
Practice Address - Street 2:SUITE #205
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3648
Practice Address - Country:US
Practice Address - Phone:703-522-7300
Practice Address - Fax:703-522-0495
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236537208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I27263Medicare UPIN