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General NPI Number Information
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NPI Number | 1194198713
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Entity Type | Organization
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Legal Business Name | BE WELL MEDICAL GROUP
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 108 S COLUMBUS ST SUITE 201
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3064
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Country | US
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Telephone | 800-807-7854
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Fax |
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Provider Business Mailing Address
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Address Line | 720 RIVER MIST DR
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City | OXON HILL
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State | MD
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Zip | 20745-3475
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LISA ASHE
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Credential | D.O.
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Telephone | 800-807-7854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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