Healthcare Provider Details

I. General information

NPI: 1497856793
Provider Name (Legal Business Name): GENERAL INTERNAL MEDICINE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3022 WILLIAMS DRIVE SUITE 300
FAIRFAX VA
22031
US

IV. Provider business mailing address

3022 WILLIAMS DRIVE SUITE 300
FAIRFAX VA
22031
US

V. Phone/Fax

Practice location:
  • Phone: 703-573-9800
  • Fax: 703-573-2959
Mailing address:
  • Phone: 703-573-9800
  • Fax: 703-573-2959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR A RUBIN
Title or Position: PRESIDENT AND MEDICAL ADVISOR
Credential: MD
Phone: 703-573-9800