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General NPI Number Information
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NPI Number | 1265584346
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Entity Type | Organization
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Legal Business Name | FAMILY MED-SURG CLINIC, LLC.
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 12/02/2009
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Provider Practice Location Address
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Address Line | 10721 MAIN ST SUITE 2100
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City | FAIRFAX
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State | VA
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Zip | 22030-6914
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Country | US
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Telephone | 703-802-6700
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Fax | 703-802-6701
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Provider Business Mailing Address
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Address Line | PO BOX 847
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City | FAIRFAX
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State | VA
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Zip | 22038-0847
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Country | US
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Telephone | 703-802-6700
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Fax | 703-802-6701
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Authorized Official
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Title or Position | OWNER
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Name | DR. AYAD A ALSAADI
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Credential | M.D.
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Telephone | 703-802-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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