| NPI | 1245297506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH ANN WALCZAK Medical Biller 703-759-2724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101033583) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2007-10-25 |