| Capital Area Physician Weight & Wellness Center, Inc | |
|
2235 Cedar Ln Ste 302 Vienna VA 22182-5247 | |
| (703) 255-6010 | |
| (703) 255-6011 |
| Full Name | Capital Area Physician Weight & Wellness Center, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2235 Cedar Ln Ste 302, Vienna, Virginia |
| Authorized Official Name and Position | Sree Gogineni (OWNER) |
| Authorized Official Contact | 7035939341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Area Physician Weight & Wellness Center, Inc 44121 Leesburg Pike Ste 250 Ashburn VA 20147-5674 Ph: (703) 255-6010 | Capital Area Physician Weight & Wellness Center, Inc 2235 Cedar Ln Ste 302 Vienna VA 22182-5247 Ph: (703) 255-6010 |
| NPI Number | 1316766181 |
|---|---|
| Provider Enumeration Date | 10/08/2024 |
| Last Update Date | 10/08/2024 |
| Medicare PECOS PAC ID | 6406381441 |
|---|---|
| Medicare Enrollment ID | O20241127001261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316766181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RB0002X | Internal Medicine - Obesity Medicine | (* (Not Available)) | Primary |
| Provider Name | Sree Lakshmi Gogineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386603736 PECOS PAC ID: 9638135759 Enrollment ID: I20041213000318 |
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