Healthcare Provider Details

I. General information

NPI: 1467629303
Provider Name (Legal Business Name): SARATOGA MEDICAL CLINIC P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7839A ROLLING RD
SPRINGFIELD VA
22153-2821
US

IV. Provider business mailing address

7839A ROLLING RD
SPRINGFIELD VA
22153-2821
US

V. Phone/Fax

Practice location:
  • Phone: 703-569-6998
  • Fax:
Mailing address:
  • Phone: 703-569-6998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number0101033011
License Number StateVA

VIII. Authorized Official

Name: DR. DILBAGH S SIDHU
Title or Position: PHYSICIAN
Credential:
Phone: 703-569-6998