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General NPI Number Information
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NPI Number | 1962243253
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Entity Type | Organization
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Legal Business Name | SOMATUS MEDICAL HOLDINGS, PC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 1861 INTERNATIONAL DR STE 600
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City | MC LEAN
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State | VA
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Zip | 22102-4420
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Country | US
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Telephone | 571-992-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 1861 INTERNATIONAL DR STE 600
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City | MC LEAN
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State | VA
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Zip | 22102-4420
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Country | US
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Telephone | 571-992-0600
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOE KIMURA
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Credential | MD
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Telephone | 571-992-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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