Ian Michael Wattenmaker, MD | |
19450 Deerfield Avenue, Suite 200, Leesburg, VA 20176-6821 | |
(703) 777-1553 | |
(703) 777-5524 |
Full Name | Ian Michael Wattenmaker |
---|---|
Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 19450 Deerfield Avenue, Suite 200, Leesburg, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629077854 | NPI | - | NPPES |
30015845120002 | Medicaid | VA | |
1629077854 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | 0101049672 (Virginia) | Primary |
Entity Name | Loudoun Medical Group, Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679591440 PECOS PAC ID: 0042119661 Enrollment ID: O20041115000474 |
Mailing Address | Practice Location Address |
---|---|
Ian Michael Wattenmaker, MD 224d Cornwall St Nw Ste 403, Leesburg, VA 20176-2704 Ph: (703) 737-6010 | Ian Michael Wattenmaker, MD 19450 Deerfield Avenue, Suite 200, Leesburg, VA 20176-6821 Ph: (703) 777-1553 |
Dr. Nauman J Akhtar, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 224-d Cornwall Street Nw, Suite 204, Leesburg, VA 20176 Phone: 703-777-3262 Fax: 703-777-3365 | |
Matthew Bernard Gavin, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 224-d Cornwall Street, Nw, Suite 204,, Leesburg, VA 20176 Phone: 703-777-3262 Fax: 703-777-3365 | |
Raymond Francis Lower, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 19465 Deerfield Ave Ste 405, Leesburg, VA 20176 Phone: 703-858-1800 Fax: 703-858-1801 | |
Dr. Abdurrahman Kandil, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 224-d Cornwall Street, Nw, Suite 204,, Leesburg, VA 20176 Phone: 703-665-2720 Fax: 703-665-2487 | |
Dr. Ali Moshirfar, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 19450 Deerfield Ave Ste 300, Leesburg, VA 20176 Phone: 703-723-6774 Fax: 703-723-1494 | |
Dr. James Ticknor Gable, DO Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176 Phone: 703-777-3262 Fax: 703-777-3365 | |
Michael Andrew Kavanagh, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 224-d Cornwall Street, Nw, Suite 204, Leesburg, VA 20176 Phone: 703-777-3262 Fax: 703-777-3365 |