| Progressive Medical Associates, Llc. | |
|
2812 Old Lee Hwy Ste 210b Fairfax VA 22031-4367 | |
| (703) 876-6131 | |
| (703) 876-6009 |
| Full Name | Progressive Medical Associates, Llc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2812 Old Lee Hwy Ste 210b, Fairfax, Virginia |
| Authorized Official Name and Position | Namrata Prasad (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 7034701061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Medical Associates, Llc. 2812 Old Lee Hwy Ste 210b Fairfax VA 22031-4367 Ph: (703) 876-6131 | Progressive Medical Associates, Llc. 2812 Old Lee Hwy Ste 210b Fairfax VA 22031-4367 Ph: (703) 876-6131 |
| NPI Number | 1750925541 |
|---|---|
| Provider Enumeration Date | 11/05/2019 |
| Last Update Date | 08/19/2020 |
| Medicare PECOS PAC ID | 0941634224 |
|---|---|
| Medicare Enrollment ID | O20191219000071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750925541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shanti Prasad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982646113 PECOS PAC ID: 3072609825 Enrollment ID: I20071010000227 |
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