| Mira Integrative Medicine & Gastroenterology | |
|
2557 Chain Bridge Rd Vienna VA 22181-5517 | |
| (703) 705-7555 | |
| Not Available |
| Full Name | Mira Integrative Medicine & Gastroenterology |
|---|---|
| Speciality | Internal Medicine |
| Location | 2557 Chain Bridge Rd, Vienna, Virginia |
| Authorized Official Name and Position | Khalid Alkimawi (DIRECTOR) |
| Authorized Official Contact | 7037329916 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mira Integrative Medicine & Gastroenterology 2557 Chain Bridge Rd Vienna VA 22181-5517 Ph: (703) 732-9916 | Mira Integrative Medicine & Gastroenterology 2557 Chain Bridge Rd Vienna VA 22181-5517 Ph: (703) 705-7555 |
| NPI Number | 1851741912 |
|---|---|
| Provider Enumeration Date | 06/20/2016 |
| Last Update Date | 12/18/2023 |
| Medicare PECOS PAC ID | 3072808898 |
|---|---|
| Medicare Enrollment ID | O20240424001166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851741912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Khalid A Alkimawi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609022094 PECOS PAC ID: 0648495408 Enrollment ID: I20210806000623 |
| Provider Name | Nashwa Abdalla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396524278 PECOS PAC ID: 9032567763 Enrollment ID: I20231119000055 |
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