| Commonwealth Of Virginia Dept Of Mental Health And Northern Virginia T | |
|
9901 Braddock Rd Fairfax VA 22032-1904 | |
| (703) 323-4093 | |
| Not Available |
| Full Name | Commonwealth Of Virginia Dept Of Mental Health And Northern Virginia T |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 9901 Braddock Rd, Fairfax, Virginia |
| Authorized Official Name and Position | Shaquwanda Baker (OFFICE MANAGER) |
| Authorized Official Contact | 7033234093 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Of Virginia Dept Of Mental Health And Northern Virginia T 9901 Braddock Rd Fairfax VA 22032-1904 Ph: (703) 323-4093 | Commonwealth Of Virginia Dept Of Mental Health And Northern Virginia T 9901 Braddock Rd Fairfax VA 22032-1904 Ph: (703) 323-4093 |
| NPI Number | 1811171309 |
|---|---|
| Provider Enumeration Date | 12/20/2007 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811171309 | NPI | - | NPPES |
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