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General NPI Number Information
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NPI Number | 1437438512
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Entity Type | Organization
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Legal Business Name | WILLIAM AND TERESA MEDICAL CARE, INC
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Dates
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Enumeration Date | 08/08/2011
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Last Update Date | 08/08/2011
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Provider Practice Location Address
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Address Line | 7516 IRON BAR LN
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City | GAINESVILLE
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State | VA
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Zip | 20155-2999
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Country | US
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Telephone | 703-754-9111
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Fax | 703-754-1211
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Provider Business Mailing Address
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Address Line | 7516 IRON BAR LN
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City | GAINESVILLE
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State | VA
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Zip | 20155-2999
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Country | US
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Telephone | 703-754-9111
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Fax | 703-754-1211
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES IHECHUKWUTURU OKORIE
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Credential | MD
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Telephone | 703-754-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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