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NPI Code Detail

MEDICARE: INNOVATIVE HEALTH SERVICES LLC

MEDICARE: INNOVATIVE HEALTH SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1508562505
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNOVATIVE HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 1530 WILSON BLVD STE 650
Second Line :
City : ARLINGTON
State : VA
Zip : 22209-2455
Country : US
Telephone Number : 703-621-1572
Fax Number :
Provider Business Practice Location Address
First Line : 1530 WILSON BLVD STE 650
Second Line :
City : ARLINGTON
State : VA
Zip : 22209-2455
Country : US
Telephone Number : 703-621-1572
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KARLA OREA
Credential :
Telephone Number : 703-621-1572
Provider Enumeration Date : 02/01/2023
Last Update Date : 02/01/2023

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Directions to “INNOVATIVE HEALTH SERVICES LLC ” Practice Location

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