| Family Medicine In Falls Church Pc | |
|
124 E Broad St Ste A Falls Church VA 22046-4530 | |
| (703) 533-7555 | |
| (703) 533-7797 |
| Full Name | Family Medicine In Falls Church Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 124 E Broad St Ste A, Falls Church, Virginia |
| Authorized Official Name and Position | Gordon Walker Theisz (PRESIDENT) |
| Authorized Official Contact | 7035337555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine In Falls Church Pc 124 E Broad St Ste A Falls Church VA 22046-4530 Ph: (703) 533-7555 | Family Medicine In Falls Church Pc 124 E Broad St Ste A Falls Church VA 22046-4530 Ph: (703) 533-7555 |
| NPI Number | 1952474306 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 01/19/2023 |
| Medicare PECOS PAC ID | 4688699945 |
|---|---|
| Medicare Enrollment ID | O20051006000299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952474306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101102617 (Virginia) | Primary |
| Provider Name | Gordon W Theisz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437101508 PECOS PAC ID: 5092746859 Enrollment ID: I20050822001325 |
| Provider Name | Arminda G Nasuti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447478425 PECOS PAC ID: 5991992687 Enrollment ID: I20180920001241 |
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