Individual ProviderStephen G SpurrPediatricsAllopathic & Osteopathic PhysiciansPractice Address3600 Joseph Siewick Dr, Fairfax, VA 22033-1709(703) 289-1400PECOS EnrollmentBased on the most recent information from CMS, provider Stephen G Spurr does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1114968641Provider TypeIndividualFull NameSpurr, Stephen GTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date6/8/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address3600 Joseph Siewick Dr, Fairfax, VA 22033-1709Phone(703) 289-1400Fax(703) 289-1414Mailing LocationMailing Address2730-B Prosperity Avenue, Fairfax, VA 22031-2238Phone(703) 289-1400Fax(703) 289-1414Provider TaxonomiesCodeDescriptionLicenseCode2080N0001XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicense0101041944VirginiaProvider IdentifiersIDDescriptionIssuerID3236940DescriptionOtherIssuerECFMGID6717837DescriptionMedicaidIssuerUnlistedVirginiaID6717845DescriptionMedicaidIssuerUnlistedVirginiaID6717578DescriptionMedicaidIssuerUnlistedVirginia