| Internal Medicine Practice Associates Pc | |
|
46090 Lake Center Plz 201 Potomac Falls VA 20165-5876 | |
| (703) 444-6544 | |
| (703) 444-1121 |
| Full Name | Internal Medicine Practice Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 46090 Lake Center Plz, Potomac Falls, Virginia |
| Authorized Official Name and Position | Alok Rustogi (DIRECTOR) |
| Authorized Official Contact | 7038805539 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Practice Associates Pc 46090 Lake Center Plz 201 Potomac Falls VA 20165-5876 Ph: (703) 444-6544 | Internal Medicine Practice Associates Pc 46090 Lake Center Plz 201 Potomac Falls VA 20165-5876 Ph: (703) 444-6544 |
| NPI Number | 1669403051 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 10/31/2011 |
| Medicare PECOS PAC ID | 3779584313 |
|---|---|
| Medicare Enrollment ID | O20070124000425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669403051 | NPI | - | NPPES |
| DF6585 | Other | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101236706 (Virginia) | Primary |
| Provider Name | Alok Rustogi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730116575 PECOS PAC ID: 2668417148 Enrollment ID: I20070124000452 |
| Provider Name | Caralyn Wilkerson Ivey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568979748 PECOS PAC ID: 9638564438 Enrollment ID: I20220314001450 |
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