Healthcare Provider Details

I. General information

NPI: 1952426942
Provider Name (Legal Business Name): FAMILY MEDICINE & ASSOCIATES OF ALEXANDRIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5249 DUKE ST #100
ALEXANDRIA VA
22304-2926
US

IV. Provider business mailing address

5249 DUKE ST #100
ALEXANDRIA VA
22304-2926
US

V. Phone/Fax

Practice location:
  • Phone: 703-370-2814
  • Fax: 703-370-7214
Mailing address:
  • Phone: 703-370-2814
  • Fax: 703-370-7214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MIRELA L MIRCEA
Title or Position: PRESIDENT
Credential: MD
Phone: 703-370-2814