| Virginia Id Doctors Llc | |
|
1860 Town Center Dr Ste 310 Reston VA 20190-5899 | |
| (703) 738-9989 | |
| (703) 738-9991 |
| Full Name | Virginia Id Doctors Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1860 Town Center Dr Ste 310, Reston, Virginia |
| Authorized Official Name and Position | Lavanya Nutankalva (PRESIDENT) |
| Authorized Official Contact | 5714779909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Id Doctors Llc 4437 Brookfield Corporate Dr Ste 101 Chantilly VA 20151-2122 Ph: (703) 738-9989 | Virginia Id Doctors Llc 1860 Town Center Dr Ste 310 Reston VA 20190-5899 Ph: (703) 738-9989 |
| NPI Number | 1952812364 |
|---|---|
| Provider Enumeration Date | 10/12/2017 |
| Last Update Date | 07/10/2023 |
| Medicare PECOS PAC ID | 8123387750 |
|---|---|
| Medicare Enrollment ID | O20180105000438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952812364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 0101240702 (Virginia) | Primary |
| Provider Name | Lavanya Nutankalva |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003997339 PECOS PAC ID: 7012946734 Enrollment ID: I20050811000974 |
Loudoun Medical Group, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Town Center Dr Suite 214, Reston, VA 20190 Phone: 703-478-0325 Fax: 703-478-2702 | |
Tlc The Laser Center (northeast) Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10790 Parkridge Blvd, Ste. 105, Reston, VA 20191 Phone: 703-860-2000 | |
Orthovirginia, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Town Center Parkway, Suite 400, Reston, VA 20190 Phone: 703-810-5202 | |
Sai Healthcare Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1830 Town Center Dr, Ste 303, Reston, VA 20190 Phone: 703-435-0700 Fax: 703-435-0660 | |
Janet Avery Md Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1860 Town Center Dr, Suite 310, Reston, VA 20190 Phone: 703-481-5907 Fax: 703-435-0660 | |
Avicenna Health & Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1860 Town Center Dr Ste 340, Reston, VA 20190 Phone: 703-943-7475 | |
Gwilym Parry Mdpc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1830 Town Center Dr Ste 207, Reston, VA 20190 Phone: 703-435-2227 Fax: 703-435-7856 |