MEDICARE: RIDGEVIEW INTERNAL MEDICINE

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K792	OTHER	VA	CAREFIRST

General Provider Information

NPI Number	:	1861437139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIDGEVIEW INTERNAL MEDICINE

Provider Business Mailing Address
First Line	:	2000 OPITZ BLVD
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191
Country	:	US
Telephone Number	:	703-499-9144
Fax Number	:	703-497-0051

Provider Business Practice Location Address
First Line	:	2000 OPITZ BLVD
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-3306
Country	:	US
Telephone Number	:	703-499-9144
Fax Number	:	703-497-0051

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. NIZAR HUSSAIN
Credential	:	M.D.
Telephone Number	:	703-494-4116

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	02/05/2008

Similar Medicare Providers

1366138521 — SUNITA ADHIKARI
Practice Location Address:

2000 OPITZ BLVD
WOODBRIDGE, VA
22191-3306

Practice Phone: 703-494-4116
Practice Fax:

1508868225 — GEORGE N BAKALIS D.C.
Practice Location Address:

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22191-3306

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1023008976 — DR. NIZAR MOHAMED HUSSAIN MD
Practice Location Address:

2000 OPITZ BLVD
WOODBRIDGE, VA
22191-3306

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Practice Fax: 703-497-0051

1467416305 — DR. DOUGLAS EDWIN HERITAGE M.D.09
Practice Location Address:

2026A OPITZ BLVD
WOODBRIDGE, VA
22191-3306

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1629090501 — RICHARD J HWANG MD PC
Practice Location Address:

2022 OPITZ BLVD , SUITE A
WOODBRIDGE, VA
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1457450918 — NOVA ORTHOPEDIC & SPINE CARE, PC
Practice Location Address:

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Directions to “RIDGEVIEW INTERNAL MEDICINE ” Practice Location

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