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General NPI Number Information
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NPI Number | 1922345313
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Entity Type | Organization
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Legal Business Name | WITHINME MD
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 5275 LEE HWY STE 101
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City | ARLINGTON
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State | VA
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Zip | 22207-1619
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Country | US
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Telephone | 804-441-5040
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Fax |
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Provider Business Mailing Address
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Address Line | 5275 LEE HWY STE 101
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City | ARLINGTON
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State | VA
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Zip | 22207-1619
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Country | US
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Telephone | 804-441-5040
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL DIRECTOR
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Name | DR. DERRON SIMON
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Credential | M.D.
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Telephone | 703-430-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0101232169
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License Number State | VA
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