| Virginia Functional Medicine Inc | |
|
19465 Deerfield Ave Ste 308 Leesburg VA 20176-1701 | |
| (703) 938-1421 | |
| (703) 938-1424 |
| Full Name | Virginia Functional Medicine Inc |
|---|---|
| Speciality | Preventive Medicine |
| Location | 19465 Deerfield Ave Ste 308, Leesburg, Virginia |
| Authorized Official Name and Position | Nathaniel David Goren (C.O.O.) |
| Authorized Official Contact | 7039381421 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Functional Medicine Inc 19465 Deerfield Ave Ste 308 Leesburg VA 20176-1701 Ph: (571) 595-2610 | Virginia Functional Medicine Inc 19465 Deerfield Ave Ste 308 Leesburg VA 20176-1701 Ph: (703) 938-1421 |
| NPI Number | 1295495331 |
|---|---|
| Provider Enumeration Date | 12/29/2021 |
| Last Update Date | 10/31/2025 |
| Certification Date | 10/31/2025 |
| Medicare PECOS PAC ID | 4880030345 |
|---|---|
| Medicare Enrollment ID | O20240307000878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295495331 | NPI | - | NPPES |
| Provider Name | Rajesh N Mehra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992873400 PECOS PAC ID: 7810012176 Enrollment ID: I20260109002001 |
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