| Internal Medicine Practice, P.c. | |
|
8233 Old Courthouse Rd Suite 170 Vienna VA 22182-3816 | |
| (703) 556-9318 | |
| (703) 448-8839 |
| Full Name | Internal Medicine Practice, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 8233 Old Courthouse Rd, Vienna, Virginia |
| Authorized Official Name and Position | Sandra Tirado (PHYSICIAN) |
| Authorized Official Contact | 7035569318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Practice, P.c. 8233 Old Courthouse Rd Suite 170 Vienna VA 22182-3816 Ph: (703) 556-9318 | Internal Medicine Practice, P.c. 8233 Old Courthouse Rd Suite 170 Vienna VA 22182-3816 Ph: (703) 556-9318 |
| NPI Number | 1013121508 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 07/14/2011 |
| Medicare PECOS PAC ID | 0840250437 |
|---|---|
| Medicare Enrollment ID | O20041018000954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013121508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0101038420 (Virginia) | Primary |
| Provider Name | Neda Motameni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184887895 PECOS PAC ID: 1557541158 Enrollment ID: I20190321002342 |
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