| Family Health Center | |
|
1850 Town Center Pkwy Ste 207 Reston VA 20190-3219 | |
| (703) 478-9390 | |
| Not Available |
| Full Name | Family Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1850 Town Center Pkwy Ste 207, Reston, Virginia |
| Authorized Official Name and Position | Eric S Havens (OWNER) |
| Authorized Official Contact | 7038347584 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Center 1850 Town Center Pkwy Ste 207 Reston VA 20190-3219 Ph: (703) 478-9390 | Family Health Center 1850 Town Center Pkwy Ste 207 Reston VA 20190-3219 Ph: (703) 478-9390 |
| NPI Number | 1366729675 |
|---|---|
| Provider Enumeration Date | 11/15/2011 |
| Last Update Date | 11/15/2011 |
| Medicare PECOS PAC ID | 6800062001 |
|---|---|
| Medicare Enrollment ID | O20120109000881 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366729675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Eric S Havens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396961025 PECOS PAC ID: 1759557994 Enrollment ID: I20120110000318 |
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