| Northern Virginia Healthcare, P.c | |
|
3930 Pender Dr Ste 270 Fairfax VA 22030-0986 | |
| (703) 698-1600 | |
| (703) 359-7814 |
| Full Name | Northern Virginia Healthcare, P.c |
|---|---|
| Speciality | Internal Medicine |
| Location | 3930 Pender Dr Ste 270, Fairfax, Virginia |
| Authorized Official Name and Position | Andrea L Butler (OFFICE MANAGER) |
| Authorized Official Contact | 6145178151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Virginia Healthcare, P.c 3930 Pender Dr Ste 270 Fairfax VA 22030-0986 Ph: (703) 698-1600 | Northern Virginia Healthcare, P.c 3930 Pender Dr Ste 270 Fairfax VA 22030-0986 Ph: (703) 698-1600 |
| NPI Number | 1922603257 |
|---|---|
| Provider Enumeration Date | 12/03/2020 |
| Last Update Date | 12/03/2020 |
| Medicare PECOS PAC ID | 2264837301 |
|---|---|
| Medicare Enrollment ID | O20210826003551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922603257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Albert Walter Hattwick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356496988 PECOS PAC ID: 2668576612 Enrollment ID: I20110126000136 |
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