| NPI | 1417045816 |
|---|---|
| Other Name | FAMILY MEDICINE OF LAKE RIDGE |
| Entity Type | Organization |
| Authorized Contact | GERRY A COPE Physician 703-490-6265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101040586) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101039027) |
| 207Q00000X Family Medicine (Licence: VA 0024057411) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |