| Mdwatch Medical Corp. | |
|
10304 Eaton Pl Ste 100 Fairfax VA 22030-2221 | |
| (888) 202-9960 | |
| (888) 355-4954 |
| Full Name | Mdwatch Medical Corp. |
|---|---|
| Speciality | Family Medicine |
| Location | 10304 Eaton Pl Ste 100, Fairfax, Virginia |
| Authorized Official Name and Position | Vishal Verma (CEO) |
| Authorized Official Contact | 8587529735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdwatch Medical Corp. 13280 Evening Creek Dr S Ste 225 San Diego CA 92128-4664 Ph: (858) 752-9735 | Mdwatch Medical Corp. 10304 Eaton Pl Ste 100 Fairfax VA 22030-2221 Ph: (888) 202-9960 |
| NPI Number | 1548842370 |
|---|---|
| Provider Enumeration Date | 04/21/2021 |
| Last Update Date | 09/26/2023 |
| Medicare PECOS PAC ID | 3870992670 |
|---|---|
| Medicare Enrollment ID | O20210527002367 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548842370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Jason Michael Phillips |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417120387 PECOS PAC ID: 4486872991 Enrollment ID: I20210601000814 |
| Provider Name | Samir Damani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457379372 PECOS PAC ID: 9830194406 Enrollment ID: I20210601001015 |
| Provider Name | Elaine Briggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700105673 PECOS PAC ID: 1456545326 Enrollment ID: I20210721000956 |
| Provider Name | Maranda Mccray-dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154595304 PECOS PAC ID: 1254501992 Enrollment ID: I20211201001975 |
| Provider Name | Terri Riddiford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649279498 PECOS PAC ID: 9931173911 Enrollment ID: I20230124002791 |
| Provider Name | Gina Rigsbee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598387425 PECOS PAC ID: 5496167934 Enrollment ID: I20230202001735 |
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