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General NPI Number Information
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NPI Number | 1962825307
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Entity Type | Organization
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Legal Business Name | MEDICO FAMILY CLINIC, INC
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 6231 LEESBURG PIKE STE 200
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2102
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Country | US
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Telephone | 703-533-8872
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Fax |
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Provider Business Mailing Address
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Address Line | 6231 LEESBURG PIKE STE 200
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2102
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Country | US
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Telephone | 703-533-8872
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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. JAMAL U ZIA
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Credential | MD
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Telephone | 703-533-8872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101240975
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License Number State | VA
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