| Adult Primary Care Center Llc | |
|
2200 Opitz Blvd Suite 350 Woodbridge VA 22191-3321 | |
| (845) 426-6864 | |
| Not Available |
| Full Name | Adult Primary Care Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2200 Opitz Blvd, Woodbridge, Virginia |
| Authorized Official Name and Position | Siamak Heydarian (PRESIDENT) |
| Authorized Official Contact | 8454266864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult Primary Care Center Llc 2200 Opitz Blvd Suite 350 Woodbridge VA 22191-3321 Ph: (845) 426-6864 | Adult Primary Care Center Llc 2200 Opitz Blvd Suite 350 Woodbridge VA 22191-3321 Ph: (845) 426-6864 |
| NPI Number | 1326243395 |
|---|---|
| Provider Enumeration Date | 06/19/2007 |
| Last Update Date | 11/08/2007 |
| Medicare PECOS PAC ID | 1153587399 |
|---|---|
| Medicare Enrollment ID | O20120716000609 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326243395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101048248 (Virginia) | Primary |
| Provider Name | Siamak Heydarian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225072077 PECOS PAC ID: 7416113659 Enrollment ID: I20120716000615 |
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