MEDICARE: AMS MEDICAL CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1982277257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMS MEDICAL CARE, LLC

Provider Business Mailing Address
First Line	:	731 WALKER RD UNIT 1E
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-2834
Country	:	US
Telephone Number	:	443-739-2315
Fax Number	:

Provider Business Practice Location Address
First Line	:	731 WALKER RD UNIT 1E
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-2834
Country	:	US
Telephone Number	:	703-862-4467
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PARTNER/AUTHORIZED OFFICIAL
Name	:	DR. ALI MIREBRAHIMI-TAFRESHI
Credential	:	MD
Telephone Number	:	443-739-2315

Provider Enumeration Date	:	07/23/2021
Last Update Date	:	07/23/2021

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