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46090 Lake Center Plz Suite 106 Sterling VA 20165-5876 | |
| (703) 444-4450 | |
| (703) 444-4410 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 46090 Lake Center Plz, Sterling, Virginia |
| Authorized Official Name and Position | Farhad Zangeneh (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7034444450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
46090 Lake Center Plz Suite 106 Sterling VA 20165-5876 Ph: (703) 444-4450 | 46090 Lake Center Plz Suite 106 Sterling VA 20165-5876 Ph: (703) 444-4450 |
| NPI Number | 1487833422 |
|---|---|
| Provider Enumeration Date | 10/26/2007 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487833422 | NPI | - | NPPES |
| DE0220 | Other | VA | RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 0101233721 (Virginia) | Primary |
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