| Dulles Medical Group Llc | |
|
224d Cornwall St Nw Suite 303 Leesburg VA 20176-2700 | |
| (703) 777-8840 | |
| (703) 779-0887 |
| Full Name | Dulles Medical Group Llc |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 224d Cornwall St Nw, Leesburg, Virginia |
| Authorized Official Name and Position | Anil J Patel (PRESIDENT) |
| Authorized Official Contact | 7037778840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dulles Medical Group Llc 224d Cornwall St Nw Suite 303 Leesburg VA 20176-2700 Ph: (703) 777-8840 | Dulles Medical Group Llc 224d Cornwall St Nw Suite 303 Leesburg VA 20176-2700 Ph: (703) 777-8840 |
| NPI Number | 1053408732 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 01/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053408732 | NPI | - | NPPES |
| A840-001 | Other | VA | CAREFIRST |
| 070317 | Other | VA | BLUECROSS BLUESHIELD |
| 005842875 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 0101045895 (Virginia) | Primary |
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