Healthcare Provider Details

I. General information

NPI: 1073971610
Provider Name (Legal Business Name): PULMONARY CENTER OF NORTHERN VIRGINIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 06/10/2020
Certification Date: 06/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24585 STONE CARVER DRIVE STE 100
ALDIE VA
20105-2798
US

IV. Provider business mailing address

24585 STONE CARVER DRIVE STE 100
ALDIE VA
20105-2798
US

V. Phone/Fax

Practice location:
  • Phone: 703-542-8884
  • Fax: 571-367-4833
Mailing address:
  • Phone: 703-542-8884
  • Fax: 571-367-4833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101250738
License Number StateVA

VIII. Authorized Official

Name: DR. SUNIL S SWAMI
Title or Position: OWNER
Credential: M.D.
Phone: 703-542-8884