| Ccma | |
|
5895 Trinity Pkwy Suite 100 Centreville VA 20120-1995 | |
| (703) 802-2004 | |
| (703) 802-2113 |
| Full Name | Ccma |
|---|---|
| Speciality | Internal Medicine |
| Location | 5895 Trinity Pkwy, Centreville, Virginia |
| Authorized Official Name and Position | Alan R. Levinstone (CEO) |
| Authorized Official Contact | 7038022004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccma 5895 Trinity Pkwy Suite 100 Centreville VA 20120-1996 Ph: (703) 802-2004 | Ccma 5895 Trinity Pkwy Suite 100 Centreville VA 20120-1995 Ph: (703) 802-2004 |
| NPI Number | 1912078619 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 09/21/2015 |
| Medicare PECOS PAC ID | 7416987904 |
|---|---|
| Medicare Enrollment ID | O20050815000657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912078619 | NPI | - | NPPES |
| 006078508 | Medicaid | VA | |
| VV1662B | Other | VA | MEDICARE GBA |
| Provider Name | Alan R Levinstone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992709265 PECOS PAC ID: 8921107343 Enrollment ID: I20101115000034 |
| Provider Name | Mariya Bourget |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477870541 PECOS PAC ID: 4880880145 Enrollment ID: I20101129000445 |
| Provider Name | Malak Isaac |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922130228 PECOS PAC ID: 8022115815 Enrollment ID: I20151013000634 |
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