| Nova Internal Medicine Associates Pc | |
|
3930 Walnut St Suite 101 Fairfax VA 22030-4738 | |
| (703) 435-3333 | |
| (703) 481-3977 |
| Full Name | Nova Internal Medicine Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3930 Walnut St, Fairfax, Virginia |
| Authorized Official Name and Position | Venkateswer Addanki (PRESIDENT) |
| Authorized Official Contact | 7034353333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Internal Medicine Associates Pc Po Box 710012 Herndon VA 20171-0012 Ph: () - | Nova Internal Medicine Associates Pc 3930 Walnut St Suite 101 Fairfax VA 22030-4738 Ph: (703) 435-3333 |
| NPI Number | 1568770659 |
|---|---|
| Provider Enumeration Date | 09/22/2010 |
| Last Update Date | 03/15/2018 |
| Medicare PECOS PAC ID | 8325227887 |
|---|---|
| Medicare Enrollment ID | O20110131000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568770659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101246084 (Virginia) | Primary |
| Provider Name | Venkateswer R Addanki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851543409 PECOS PAC ID: 3971639485 Enrollment ID: I20100408000436 |
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