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General NPI Number Information
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NPI Number | 1609489483
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Entity Type | Organization
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Legal Business Name | THOMPSON MD LLC
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 3541 W BRADDOCK RD STE 100
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City | ALEXANDRIA
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State | VA
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Zip | 22302-1922
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Country | US
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Telephone | 540-675-4715
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Fax | 877-460-4228
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Provider Business Mailing Address
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Address Line | 3541 W BRADDOCK RD STE 100
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City | ALEXANDRIA
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State | VA
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Zip | 22302-1922
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Country | US
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Telephone | 540-675-4715
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Fax | 877-460-4228
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | SAIRA THOMPSON
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Credential | MD
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Telephone | 703-780-7034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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