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3914 Centreville Road, Suite 350 Chantilly VA 20151 | |
| (703) 263-3393 | |
| (703) 828-0943 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 3914 Centreville Road, Suite 350, Chantilly, Virginia |
| Authorized Official Name and Position | Mary Beth Tamasy (CEO) |
| Authorized Official Contact | 7037376010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
224-d Cornwall Street, Nw, Suite 403 Leesburg VA 20176-2704 Ph: (571) 209-1833 | 3914 Centreville Road, Suite 350 Chantilly VA 20151 Ph: (703) 263-3393 |
| NPI Number | 1215684204 |
|---|---|
| Provider Enumeration Date | 03/09/2022 |
| Last Update Date | 08/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215684204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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