| Lake Ridge | |
|
12825 Minnieville Road Lake Ridge VA 22192-9998 | |
| (703) 523-9800 | |
| Not Available |
| Full Name | Lake Ridge |
|---|---|
| Speciality | Clinic/center |
| Location | 12825 Minnieville Road, Lake Ridge, Virginia |
| Authorized Official Name and Position | Robert A Broermann (SVP/CFO) |
| Authorized Official Contact | 7574557020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Ridge 12825 Minnieville Road Lake Ridge VA 22192-9998 Ph: (703) 523-9800 | Lake Ridge 12825 Minnieville Road Lake Ridge VA 22192-9998 Ph: (703) 523-9800 |
| NPI Number | 1366718215 |
|---|---|
| Provider Enumeration Date | 03/26/2012 |
| Last Update Date | 03/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366718215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Virginia) | Primary |
Sentara Family & Internal Medicine Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12825 Minnieville Rd, Ste 202, Lake Ridge, VA 22192 Phone: 571-542-4950 Fax: 571-285-1160 | |
Amy L Friedenthal Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12512 Lake Ridge Dr Ste D, Lake Ridge, VA 22192 Phone: 703-497-5555 Fax: 703-497-1479 | |
Primary Gerontology Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4196 Merchant Plz Ste 348, Lake Ridge, VA 22192 Phone: 571-206-1650 | |
Sentara Family & Internal Medicine Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12825 Minnieville Rd, Ste 202, Lake Ridge, VA 22192 Phone: 703-780-2800 Fax: 844-700-6186 | |
Patient First - Lake Ridge Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2199 Old Bridge Rd, Lake Ridge, VA 22192 Phone: 703-357-9707 Fax: 703-357-9708 |