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General NPI Number Information
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NPI Number | 1578643326
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Entity Type | Organization
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Legal Business Name | SEVEN CORNERS FAMILY PRACTICE
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6400 SEVEN CORNERS PL SUITE M
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2032
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Country | US
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Telephone | 703-241-8768
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Fax | 703-536-6200
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Provider Business Mailing Address
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Address Line | 6400 SEVEN CORNERS PL SUITE M
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2032
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Country | US
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Telephone | 703-241-8768
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Fax | 703-536-6200
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WARREN PHILLIP HENSLEE
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Credential | M.D.
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Telephone | 703-241-8768
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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 | 0101230929
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License Number State | VA
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