| Primary Care Assoc Of Potomac Pc | |
|
1900 Opitz Blvd Suite F Woodbridge VA 22191 | |
| (703) 490-3997 | |
| (703) 491-3376 |
| Full Name | Primary Care Assoc Of Potomac Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1900 Opitz Blvd, Woodbridge, Virginia |
| Authorized Official Name and Position | Alan H Wynn (PRESIDENT) |
| Authorized Official Contact | 7034903997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Assoc Of Potomac Pc 1900 Opitz Blvd Suite F Woodbridge VA 22191 Ph: (703) 490-3997 | Primary Care Assoc Of Potomac Pc 1900 Opitz Blvd Suite F Woodbridge VA 22191 Ph: (703) 490-3997 |
| NPI Number | 1013914951 |
|---|---|
| Provider Enumeration Date | 07/07/2005 |
| Last Update Date | 05/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013914951 | NPI | - | NPPES |
| 006064043 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101040884 (Virginia) | Primary |
| 207R00000X | Internal Medicine | 0101239629 (Virginia) | Secondary |
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