| Diabetes And Endocrine Care Of Virginia, Llc | |
|
9001 Digges Rd Ste 101 Manassas VA 20110-4414 | |
| (571) 363-3082 | |
| (571) 363-3024 |
| Full Name | Diabetes And Endocrine Care Of Virginia, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9001 Digges Rd Ste 101, Manassas, Virginia |
| Authorized Official Name and Position | Alejandro Santos Leal (OWNER) |
| Authorized Official Contact | 3123154293 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes And Endocrine Care Of Virginia, Llc 9001 Digges Rd Ste 101 Manassas VA 20110-4414 Ph: (571) 363-3082 | Diabetes And Endocrine Care Of Virginia, Llc 9001 Digges Rd Ste 101 Manassas VA 20110-4414 Ph: (571) 363-3082 |
| NPI Number | 1659890663 |
|---|---|
| Provider Enumeration Date | 09/12/2017 |
| Last Update Date | 01/30/2019 |
| Medicare PECOS PAC ID | 6406113752 |
|---|---|
| Medicare Enrollment ID | O20171122000699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659890663 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 0101263059 (Virginia) | Primary |
| Provider Name | Alejandro Santos Leal |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1780847111 PECOS PAC ID: 9739376682 Enrollment ID: I20171122000831 |
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