| Internal Medicine Center P.l.c | |
|
107 E Holly Ave Ste 3 Sterling VA 20164-5405 | |
| (703) 435-5510 | |
| (703) 435-3147 |
| Full Name | Internal Medicine Center P.l.c |
|---|---|
| Speciality | Internal Medicine |
| Location | 107 E Holly Ave, Sterling, Virginia |
| Authorized Official Name and Position | Ann Mecherikunnel (PRESIDENT) |
| Authorized Official Contact | 7034355510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Center P.l.c Po Box 650580 Sterling VA 20165-0580 Ph: (703) 435-5510 | Internal Medicine Center P.l.c 107 E Holly Ave Ste 3 Sterling VA 20164-5405 Ph: (703) 435-5510 |
| NPI Number | 1255512992 |
|---|---|
| Provider Enumeration Date | 11/23/2007 |
| Last Update Date | 11/23/2007 |
| Medicare PECOS PAC ID | 2769473891 |
|---|---|
| Medicare Enrollment ID | O20050523000290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255512992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101221278 (Virginia) | Primary |
| Provider Name | Ann Mecherikunnel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861442758 PECOS PAC ID: 7012908148 Enrollment ID: I20121204000154 |
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