| Shriharsh Pole, Md Pc | |
|
14904 Jefferson Davis Hwy Suite 205 Woodbridge VA 22191-3908 | |
| (703) 497-4500 | |
| (703) 494-4671 |
| Full Name | Shriharsh Pole, Md Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 14904 Jefferson Davis Hwy, Woodbridge, Virginia |
| Authorized Official Name and Position | Shriharsh L Pole (PRESIDENT) |
| Authorized Official Contact | 7034974500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shriharsh Pole, Md Pc 14904 Jefferson Davis Hwy Suite 205 Woodbridge VA 22191-3908 Ph: (703) 497-4500 | Shriharsh Pole, Md Pc 14904 Jefferson Davis Hwy Suite 205 Woodbridge VA 22191-3908 Ph: (703) 497-4500 |
| NPI Number | 1811922370 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 11/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811922370 | NPI | - | NPPES |
| C492 | Other | DC | BCBS DC |
| 5836166 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 0101048251 (Virginia) | Primary |
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