| Ehs Corporate Care | |
|
12040 S Lakes Dr Suite 205 Reston VA 20191-1246 | |
| (703) 230-6990 | |
| (703) 230-6980 |
| Full Name | Ehs Corporate Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 12040 S Lakes Dr, Reston, Virginia |
| Authorized Official Name and Position | John P Mamana (OWNER) |
| Authorized Official Contact | 7032306990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ehs Corporate Care 12040 S Lakes Dr Suite 205 Reston VA 20191-1246 Ph: (703) 230-6990 | Ehs Corporate Care 12040 S Lakes Dr Suite 205 Reston VA 20191-1246 Ph: (703) 230-6990 |
| NPI Number | 1528386224 |
|---|---|
| Provider Enumeration Date | 05/06/2010 |
| Last Update Date | 05/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528386224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101021602 (Virginia) | Primary |
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