| Maturi Medical Group Llc | |
|
2751 Prosperity Ave Ste 440 Fairfax VA 22031-4397 | |
| (703) 505-0204 | |
| Not Available |
| Full Name | Maturi Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2751 Prosperity Ave Ste 440, Fairfax, Virginia |
| Authorized Official Name and Position | Martha Maturi (MD/PRESIDENT) |
| Authorized Official Contact | 7035050204 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maturi Medical Group Llc 2751 Prosperity Ave Ste 440 Fairfax VA 22031-4397 Ph: (703) 505-0204 | Maturi Medical Group Llc 2751 Prosperity Ave Ste 440 Fairfax VA 22031-4397 Ph: (703) 505-0204 |
| NPI Number | 1295223931 |
|---|---|
| Provider Enumeration Date | 04/27/2018 |
| Last Update Date | 04/30/2018 |
| Medicare PECOS PAC ID | 7113282336 |
|---|---|
| Medicare Enrollment ID | O20180517001311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295223931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Martha M Maturi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508982414 PECOS PAC ID: 6305029471 Enrollment ID: I20110328000255 |
| Provider Name | Jung De Thouars |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699239293 PECOS PAC ID: 1951641794 Enrollment ID: I20221209002132 |
| Provider Name | Jung De Thouars |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699239293 PECOS PAC ID: 1951641794 Enrollment ID: I20221209002237 |
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