MEDICARE: EAST COAST PHYSICIANS PC

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
1	207R00000X	Internal Medicine Physician	0101236651	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841209244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST COAST PHYSICIANS PC

Provider Business Mailing Address
First Line	:	525B EUCLID AVE
Second Line	:
City	:	COLONIAL BEACH
State	:	VA
Zip	:	22443-1907
Country	:	US
Telephone Number	:	804-224-7890
Fax Number	:

Provider Business Practice Location Address
First Line	:	525B EUCLID AVE
Second Line	:
City	:	COLONIAL BEACH
State	:	VA
Zip	:	22443-1907
Country	:	US
Telephone Number	:	804-224-7890
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. HASAN FARKHANI
Credential	:
Telephone Number	:	804-224-7890

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	10/31/2011

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