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General NPI Number Information
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NPI Number | 1023767902
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Entity Type | Organization
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Legal Business Name | MARSHALL FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 03/20/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 4197 WINCHESTER RD
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City | MARSHALL
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State | VA
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Zip | 20115-3252
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Country | US
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Telephone | 703-657-9612
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Fax |
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Provider Business Mailing Address
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Address Line | 4197C WINCHESTER RD
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City | MARSHALL
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State | VA
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Zip | 20115-3252
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Country | US
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Telephone | 540-364-8199
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Fax | 540-360-9889
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | THUY LAN THI OLSON
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Credential |
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Telephone | 540-364-8199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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