Provider Demographics
NPI:1194906743
Name:ORTHOPEDIC HAND CENTER P.L.C
Entity type:Organization
Organization Name:ORTHOPEDIC HAND CENTER P.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MECHERIKUNNEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-435-5510
Mailing Address - Street 1:PO BOX 650580
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-0580
Mailing Address - Country:US
Mailing Address - Phone:703-435-5510
Mailing Address - Fax:703-435-3147
Practice Address - Street 1:107 E HOLLY AVE
Practice Address - Street 2:STE 3
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-5405
Practice Address - Country:US
Practice Address - Phone:703-435-5510
Practice Address - Fax:703-435-3147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-23
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058145207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA200001100Medicare PIN
DCG00457Medicare PIN