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General NPI Number Information
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NPI Number | 1922105477
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Entity Type | Organization
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Legal Business Name | GERIATRICS GROUP OF NORTHERN VIRGINIA,INC.
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 611 S. CARLIN SPRINGS ROAD SUIT # 514
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City | ARLINGTON
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State | VA
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Zip | 22204-1064
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Country | US
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Telephone | 571-527-0932
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Fax | 571-527-0824
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Provider Business Mailing Address
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Address Line | 5720 MERTON COURT # 371
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City | ALEXANDRIA
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State | VA
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Zip | 22311-5956
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Country | US
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Telephone | 571-527-0932
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Fax | 571-527-0824
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Authorized Official
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Title or Position | PRESIDENT
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Name | MUHAMMAD A. ALI
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Credential | M.D.
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Telephone | 703-338-9526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 010234864
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License Number State | VA
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