| Millennium Medical Center Llc | |
|
3606 Forest Dr Alexandria VA 22302-1005 | |
| (703) 820-7520 | |
| Not Available |
| Full Name | Millennium Medical Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3606 Forest Dr, Alexandria, Virginia |
| Authorized Official Name and Position | Shayma Al-mudhafar (PRESIDENT) |
| Authorized Official Contact | 7038207520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Medical Center Llc 3606 Forest Dr Alexandria VA 22302-1005 Ph: (703) 820-7520 | Millennium Medical Center Llc 3606 Forest Dr Alexandria VA 22302-1005 Ph: (703) 820-7520 |
| NPI Number | 1689909897 |
|---|---|
| Provider Enumeration Date | 10/06/2009 |
| Last Update Date | 10/06/2009 |
| Medicare PECOS PAC ID | 7012040553 |
|---|---|
| Medicare Enrollment ID | O20100804000193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689909897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101242652 (Virginia) | Primary |
| Provider Name | Shayma J Al-mudhafar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538340708 PECOS PAC ID: 1850444654 Enrollment ID: I20090727000451 |
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