| Internal Medicine Group Of Northern Virginia, Ltd. | |
|
1850 Town Center Pkwy # 314 Reston VA 20190-3219 | |
| (703) 481-5212 | |
| Not Available |
| Full Name | Internal Medicine Group Of Northern Virginia, Ltd. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1850 Town Center Pkwy # 314, Reston, Virginia |
| Authorized Official Name and Position | Suzanne Olson-cleveland (MANAGER) |
| Authorized Official Contact | 7034815212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Group Of Northern Virginia, Ltd. 1850 Town Center Pkwy # 314 Reston VA 20190-3219 Ph: (703) 481-5212 | Internal Medicine Group Of Northern Virginia, Ltd. 1850 Town Center Pkwy # 314 Reston VA 20190-3219 Ph: (703) 481-5212 |
| NPI Number | 1427178466 |
|---|---|
| Provider Enumeration Date | 03/31/2007 |
| Last Update Date | 05/02/2008 |
| Medicare PECOS PAC ID | 8820251549 |
|---|---|
| Medicare Enrollment ID | O20120516000553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427178466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | James W Cleveland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063532182 PECOS PAC ID: 9537322250 Enrollment ID: I20120517000017 |
| Provider Name | Cynthia A Burns |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700876372 PECOS PAC ID: 5496722753 Enrollment ID: I20171020001279 |
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