| One Health Medical Care, Llc | |
|
1850 Town Center Drive Suite 410 Reston VA 20190-3219 | |
| (571) 572-9054 | |
| (571) 482-6080 |
| Full Name | One Health Medical Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1850 Town Center Drive, Reston, Virginia |
| Authorized Official Name and Position | Mingliarti Tjahjana (OWNER/CEO) |
| Authorized Official Contact | 5715729198 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| One Health Medical Care, Llc 1850 Town Center Drive Suite 410 Reston VA 20190-3219 Ph: (571) 572-9054 | One Health Medical Care, Llc 1850 Town Center Drive Suite 410 Reston VA 20190-3219 Ph: (571) 572-9054 |
| NPI Number | 1598291791 |
|---|---|
| Provider Enumeration Date | 05/08/2017 |
| Last Update Date | 05/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598291791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101236144 (Virginia) | Primary |
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