Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Kevin S Fuller, PA-C

Individual provider Physician Assistant · NPI 1417119652

Mr. Kevin S Fuller, PA-C is a Physician Assistant in Fairfax, Virginia. Works from 2 locations. Licensed in Virginia.

Licensed in
VA
In the registry since
2008
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

13135 Lee Jackson Memorial Hwy Ste 305
Fairfax, VA 22033-1907
Phone: (703) 359-8640
Fax: (703) 591-6105
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3620 Joseph Siewick Dr, Fairfax, VA 22033-1756 — (703) 359-8640

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110001208 (VA)

Record details

NPI number1417119652
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 30, 2008
Last updated in NPPESApril 21, 2021
Certification dateApril 21, 2021

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