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General NPI Number Information
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NPI Number | 1508875584
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Entity Type | Organization
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Legal Business Name | URGENT MEDICAL CARE OF LAKE-RIDGE,INC.
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 7598 TELEGRAPH ROAD
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City | ALEXANDRIA
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State | VA
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Zip | 22315-3829
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Country | US
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Telephone | 703-778-0400
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Fax | 703-778-0444
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Provider Business Mailing Address
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Address Line | 14527 JEFFERSON DAVIS HWY
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City | WOODBRIDGE
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State | VA
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Zip | 22191-2817
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Country | US
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Telephone | 703-497-1234
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Fax | 703-499-9988
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MRS. RANA MAHESHINDER JIT SANDHAR
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Credential | M.SC.
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Telephone | 703-497-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 0101040696
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License Number State | VA
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Taxonomy #2
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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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