| Piedmont Otolaryngology Head & Neck Surgery | |
|
8303 Arlington Blvd Ste 203 Fairfax VA 22031-2903 | |
| (703) 573-3177 | |
| (703) 573-3780 |
| Full Name | Piedmont Otolaryngology Head & Neck Surgery |
|---|---|
| Speciality | Clinic/Center |
| Location | 8303 Arlington Blvd Ste 203, Fairfax, Virginia |
| Authorized Official Name and Position | Gopesh K Sharma (PRESIDENT) |
| Authorized Official Contact | 7035733177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Piedmont Otolaryngology Head & Neck Surgery 8303 Arlington Blvd Ste 203 Fairfax VA 22031-2903 Ph: (703) 573-3177 | Piedmont Otolaryngology Head & Neck Surgery 8303 Arlington Blvd Ste 203 Fairfax VA 22031-2903 Ph: (703) 573-3177 |
| NPI Number | 1477790228 |
|---|---|
| Provider Enumeration Date | 01/15/2009 |
| Last Update Date | 11/14/2011 |
| Medicare PECOS PAC ID | 7113192832 |
|---|---|
| Medicare Enrollment ID | O20111208000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477790228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Gopesh K Sharma |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1194822783 PECOS PAC ID: 5890960512 Enrollment ID: I20111208000298 |
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