| Alliance Medical Group | |
|
8013 Colorado Springs Dr Springfield VA 22153-2751 | |
| (571) 430-5951 | |
| Not Available |
| Full Name | Alliance Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 8013 Colorado Springs Dr, Springfield, Virginia |
| Authorized Official Name and Position | Derek Mercer (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5714305951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Medical Group 8013 Colorado Springs Dr Springfield VA 22153-2751 Ph: (571) 430-5951 | Alliance Medical Group 8013 Colorado Springs Dr Springfield VA 22153-2751 Ph: (571) 430-5951 |
| NPI Number | 1457943987 |
|---|---|
| Provider Enumeration Date | 02/05/2021 |
| Last Update Date | 02/05/2021 |
| Medicare PECOS PAC ID | 0941615322 |
|---|---|
| Medicare Enrollment ID | O20210217000695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457943987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Wesam Hassen Moustafa Hussein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043539919 PECOS PAC ID: 5890977763 Enrollment ID: I20131202000207 |
| Provider Name | Kourosh Houdsony |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255578506 PECOS PAC ID: 3779754486 Enrollment ID: I20210217000826 |
| Provider Name | Shahzad Haider |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619260379 PECOS PAC ID: 6709003361 Enrollment ID: I20210223002282 |
| Provider Name | Yasser Khoudeir |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568430817 PECOS PAC ID: 4789657396 Enrollment ID: I20210226000114 |
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