Provider Demographics
NPI:1538116710
Name:KAAS, MY HOA (DPM)
Entity type:Individual
Prefix:DR
First Name:MY HOA
Middle Name:
Last Name:KAAS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2826 OLD LEE HWY
Mailing Address - Street 2:STE 220
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4348
Mailing Address - Country:US
Mailing Address - Phone:703-573-4791
Mailing Address - Fax:703-573-4791
Practice Address - Street 1:2826 OLD LEE HWY
Practice Address - Street 2:SUITE #220
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4323
Practice Address - Country:US
Practice Address - Phone:703-205-0667
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1PD0031143213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U90345Medicare UPIN