Chantilly Family Medicine LLC
Family Medicine in Chantilly, VA. Organization (NPI-2).
NPI number1306106182
StatusActive
Last updated in NPPESAug 31, 2023
Details
- NPI
- 1306106182
- Entity type
- Organization (NPI-2)
- Legal business name
- Chantilly Family Medicine LLC
- Organization subpart
- No
- Enumeration date
- May 25, 2012
- Certification date
- Aug 31, 2023
- Last updated
- Aug 31, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | 0101242454 | VA | |
| 208000000X | Pediatrics | – | – |
Practice location
14113 Robert Paris CtChantilly, VA 20151-4200
Phone 703-956-6757 · Fax 855-359-2261
Mailing address
14113 Robert Paris CtChantilly, VA 20151-4200
Phone 039-566-7577 · Fax 855-359-2261
Other practice locations
24430 Stone Springs Blvd Ste 315
Sterling, VA 20166-2268
Sterling, VA 20166-2268
Phone 571-758-2350 · Fax 855-359-2261
Authorized official
Kanika Govil
President
7035998463
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