Healthcare Provider Details

I. General information

NPI: 1740443183
Provider Name (Legal Business Name): MILLENIUM MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13168 CENTERPOINTE WAY STE 101
WOODBRIDGE VA
22193-5287
US

IV. Provider business mailing address

6356 HOADLY RD
MANASSAS VA
20112-3422
US

V. Phone/Fax

Practice location:
  • Phone: 703-730-2000
  • Fax: 703-730-6767
Mailing address:
  • Phone: 703-590-5999
  • Fax: 703-590-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ARUN KUMAR SEKARAN
Title or Position: CEO
Credential:
Phone: 703-868-2713