| Revive Medicine Llc | |
|
3998 Fair Ridge Dr Ste 270 Fairfax VA 22033-2907 | |
| (571) 544-8110 | |
| Not Available |
| Full Name | Revive Medicine Llc |
|---|---|
| Speciality | Family Medicine - Obesity Medicine |
| Location | 3998 Fair Ridge Dr Ste 270, Fairfax, Virginia |
| Authorized Official Name and Position | Nancy Selim (PRINCIPAL) |
| Authorized Official Contact | 9517417258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Medicine Llc 5423 Marlstone Ln Fairfax VA 22030-5834 Ph: (951) 741-7258 | Revive Medicine Llc 3998 Fair Ridge Dr Ste 270 Fairfax VA 22033-2907 Ph: (571) 544-8110 |
| NPI Number | 1013618255 |
|---|---|
| Provider Enumeration Date | 03/14/2023 |
| Last Update Date | 03/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013618255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QB0002X | Family Medicine - Obesity Medicine | (* (Not Available)) | Primary |
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