| Gladstone PC Mid Atlantic PC | |
|
3025 Hamaker Ct Ste 350 Fairfax VA 22031-2243 | |
| (703) 573-6400 | |
| (703) 641-5821 |
| Full Name | Gladstone PC Mid Atlantic PC |
|---|---|
| Speciality | Family Medicine |
| Location | 3025 Hamaker Ct Ste 350, Fairfax, Virginia |
| Authorized Official Name and Position | David M Nichols (OWNER) |
| Authorized Official Contact | 7035736400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gladstone PC Mid Atlantic PC 3025 Hamaker Ct Ste 350 Fairfax VA 22031-2243 Ph: (703) 573-6400 | Gladstone PC Mid Atlantic PC 3025 Hamaker Ct Ste 350 Fairfax VA 22031-2243 Ph: (703) 573-6400 |
| NPI Number | 1972459089 |
|---|---|
| Provider Enumeration Date | 03/10/2026 |
| Last Update Date | 07/06/2026 |
| Certification Date | 07/06/2026 |
| Medicare PECOS PAC ID | 1759852221 |
|---|---|
| Medicare Enrollment ID | O20260605000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972459089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Arun Nag Santhosh Nag Santhosh Mallapareddi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780048264 PECOS PAC ID: 4789968942 Enrollment ID: I20250610002416 |
| Provider Name | David Michael Nichols |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336762061 PECOS PAC ID: 1052727013 Enrollment ID: I20260605000011 |
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