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General NPI Number Information
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NPI Number | 1700680444
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Entity Type | Organization
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Legal Business Name | AMERICARE NUCMED CLINIC & GENERAL PRACTICE LLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 3301 WOODBURN RD STE 102
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City | ANNANDALE
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State | VA
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Zip | 22003-6889
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Country | US
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Telephone | 703-894-0009
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 WOODBURN RD STE 102
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City | ANNANDALE
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State | VA
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Zip | 22003-6889
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Country | US
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Telephone | 703-894-0009
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NANA VINCENT
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Credential |
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Telephone | 240-424-9615
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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