| Internal Medicine-direct Primary Care Pc | |
|
44081 Pipeline Plz Ste 200 Ashburn VA 20147-5892 | |
| (703) 651-5910 | |
| Not Available |
| Full Name | Internal Medicine-direct Primary Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 44081 Pipeline Plz Ste 200, Ashburn, Virginia |
| Authorized Official Name and Position | Mamta Ojha (CEO) |
| Authorized Official Contact | 7036515910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine-direct Primary Care Pc 44081 Pipeline Plz Ste 200 Ashburn VA 20147-5892 Ph: (703) 651-5910 | Internal Medicine-direct Primary Care Pc 44081 Pipeline Plz Ste 200 Ashburn VA 20147-5892 Ph: (703) 651-5910 |
| NPI Number | 1134714173 |
|---|---|
| Provider Enumeration Date | 03/02/2021 |
| Last Update Date | 08/22/2023 |
| Medicare PECOS PAC ID | 1456767938 |
|---|---|
| Medicare Enrollment ID | O20210308001958 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134714173 | NPI | - | NPPES |
| 1134714173 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mamta Ojha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215220389 PECOS PAC ID: 2769601301 Enrollment ID: I20181116001681 |
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