1679800619 NPI number — VIRGINIA INTERNAL MEDICINE, PC AND URGENT CARE SERVICES, INC.

Table of content: (NPI 1679800619)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679800619 NPI number — VIRGINIA INTERNAL MEDICINE, PC AND URGENT CARE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIRGINIA INTERNAL MEDICINE, PC AND URGENT CARE SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NANA OSEI AMOAH, MD: VIRGINIA INTERNAL MEDICINE, PC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679800619
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6715 LITTLE RIVER TPKE
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
ANNANDALE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22003-3546
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-942-7339
Provider Business Mailing Address Fax Number:
703-942-7448

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6715 LITTLE RIVER TPKE
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
ANNANDALE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22003-3546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-942-7339
Provider Business Practice Location Address Fax Number:
703-942-7448
Provider Enumeration Date:
11/12/2009

Additional Information

Authorized Official

Authorized Official Last Name:
AMOAH
Authorized Official First Name:
NANA
Authorized Official Middle Name:
O
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
703-942-7339

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  0101245529 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QU0200X , with the licence number: 0101245529 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 281P00000X , with the licence number: 0101245529 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282E00000X , with the licence number: 0101245529 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 0101245529 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1962646596 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com