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General NPI Number Information
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NPI Number | 1871020651
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Entity Type | Organization
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Legal Business Name | VIRGINIA INTERNAL MEDICINE SPECIALISTS LLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 08/31/2017
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Provider Practice Location Address
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Address Line | 44790 MAYNARD SQ STE 320
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City | ASHBURN
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State | VA
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Zip | 20147-6514
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Country | US
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Telephone | 571-206-8696
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Fax | 866-383-4386
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Provider Business Mailing Address
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Address Line | 44790 MAYNARD SQ STE 320
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City | ASHBURN
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State | VA
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Zip | 20147-6514
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Country | US
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Telephone | 571-206-8696
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VANDANA PALAGIRI
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Credential | M.D.
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Telephone | 703-868-3011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 0101250130
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 0101250130
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0101250130
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License Number State | VA
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