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General NPI Number Information
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NPI Number | 1750938213
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Entity Type | Organization
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Legal Business Name | EN SANTE CLINIC & MEDICAL SPA PLLC
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 1420 SPRING HILL RD STE 160
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City | MC LEAN
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State | VA
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Zip | 22102-3025
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Country | US
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Telephone | 703-888-8589
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 CLAUDE CT
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City | GREAT FALLS
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State | VA
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Zip | 22066-1822
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Country | US
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Telephone | 425-417-2968
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ADELINE COLEMAN
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Credential |
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Telephone | 425-417-2968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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