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General NPI Number Information
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NPI Number | 1295025021
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE PRACTICE FOR WEIGHT LOSS AND SMOKERS PC
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 7501 LITTLE RIVER TPKE STE 103
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City | ANNANDALE
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State | VA
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Zip | 22003-2923
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Country | US
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Telephone | 703-256-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 LITTLE RIVER TPKE STE 103
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City | ANNANDALE
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State | VA
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Zip | 22003-2923
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Country | US
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Telephone | 703-256-1335
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY HSIAO
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Credential | MD
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Telephone | 703-256-1335
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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 | 0101051072
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License Number State | VA
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