| The Fountain Group | |
|
1900 Reston Metro Plz Ste 600 Reston VA 20190-5952 | |
| (929) 603-9612 | |
| Not Available |
| Full Name | The Fountain Group |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1900 Reston Metro Plz Ste 600, Reston, Virginia |
| Authorized Official Name and Position | Prashanth Pillai (OWNER/PHYSICIAN) |
| Authorized Official Contact | 9296039612 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Fountain Group 1900 Reston Metro Plz Ste 600 Reston VA 20190-5952 Ph: (929) 603-9612 | The Fountain Group 1900 Reston Metro Plz Ste 600 Reston VA 20190-5952 Ph: (929) 603-9612 |
| NPI Number | 1275316739 |
|---|---|
| Provider Enumeration Date | 08/17/2023 |
| Last Update Date | 08/17/2023 |
| Certification Date | 08/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275316739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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