Healthcare Provider Details

I. General information

NPI: 1679975270
Provider Name (Legal Business Name): SYNERGY URGENT CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2014
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 GALLOWS RD STE 100
TYSONS CORNER VA
22182-3913
US

IV. Provider business mailing address

1980 GALLOWS RD STE 100
TYSONS CORNER VA
22182-3913
US

V. Phone/Fax

Practice location:
  • Phone: 703-356-9899
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN CHANG
Title or Position: MANAGER
Credential: M.D.
Phone: 703-356-9899