| Leesburg Medical Clinic, Pllc | |
|
44121 Harry Byrd Hwy Ste 225 Ashburn VA 20147-5672 | |
| (703) 596-7000 | |
| (800) 609-0775 |
| Full Name | Leesburg Medical Clinic, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 44121 Harry Byrd Hwy Ste 225, Ashburn, Virginia |
| Authorized Official Name and Position | Nadya Carriger (OWNER) |
| Authorized Official Contact | 7035967000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leesburg Medical Clinic, Pllc 44121 Harry Byrd Hwy Ste 225 Ashburn VA 20147-5672 Ph: (703) 596-7000 | Leesburg Medical Clinic, Pllc 44121 Harry Byrd Hwy Ste 225 Ashburn VA 20147-5672 Ph: (703) 596-7000 |
| NPI Number | 1104198001 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104198001 | NPI | - | NPPES |
| 1819974538 | Other | VA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0024169591 (Virginia) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (Virginia) | Secondary |
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