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General NPI Number Information
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NPI Number | 1851119721
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Entity Type | Organization
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Legal Business Name | TRANSATLANTIC MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 5724 EDSALL RD SUITE B
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City | ALEXANDERIA
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State | VA
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Zip | 22304
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Country | US
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Telephone | 571-457-2115
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Fax |
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Provider Business Mailing Address
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Address Line | 8401 WHITEHEVEN CT
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City | LORTON
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State | VA
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Zip | 22079
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Country | US
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Telephone | 571-457-2115
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Fax | 281-572-8428
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Authorized Official
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Title or Position | CEO
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Name | DR. YARED W ENDAILALU
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Credential | M.D.
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Telephone | 651-399-7812
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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 |
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License Number State |
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