| Excel Medical Clinic, Inc. | |
|
14904 Jefferson Davis Hwy Suite 205 Woodbridge VA 22191-3908 | |
| (703) 497-4500 | |
| (703) 494-4671 |
| Full Name | Excel Medical Clinic, Inc. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 14904 Jefferson Davis Hwy, Woodbridge, Virginia |
| Authorized Official Name and Position | Shriharsh Laxman Pole (PRESIDENT) |
| Authorized Official Contact | 7034974500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Excel Medical Clinic, Inc. 14904 Jefferson Davis Hwy Suite 205 Woodbridge VA 22191-3908 Ph: (703) 497-4500 | Excel Medical Clinic, Inc. 14904 Jefferson Davis Hwy Suite 205 Woodbridge VA 22191-3908 Ph: (703) 497-4500 |
| NPI Number | 1164858205 |
|---|---|
| Provider Enumeration Date | 09/20/2013 |
| Last Update Date | 09/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164858205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0024166397 (Virginia) | Primary |
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