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NPI Code Detail

MEDICARE: PERSONIC VIRTUAL CLINIC LLC

MEDICARE: PERSONIC VIRTUAL CLINIC 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2261QU0200XUrgent Care Clinic/Center
3163WW0000XWound Care Registered Nurse

General Provider Information

NPI Number : 1740878420
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERSONIC VIRTUAL CLINIC LLC
Provider Business Mailing Address
First Line : 8133 LEESBURG PIKE STE 630
Second Line :
City : VIENNA
State : VA
Zip : 22182-2730
Country : US
Telephone Number : 251-901-3011
Fax Number :
Provider Business Practice Location Address
First Line : 10320 LITTLE PATUXENT PKWY STE 200
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-3344
Country : US
Telephone Number : 251-901-3011
Fax Number : 215-933-6837
Authorized Official
Title or Position : DO
Name : SYED NAQVI
Credential :
Telephone Number : 251-901-3011
Provider Enumeration Date : 01/07/2021
Last Update Date : 02/26/2024

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Directions to “PERSONIC VIRTUAL CLINIC LLC ” Practice Location

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