Provider Demographics
NPI:1699723163
Name:MIHALACHE, MONICA (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MIHALACHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 TOWN CENTER PKWY, PAVILION 2
Mailing Address - Street 2:STE 650
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190
Mailing Address - Country:US
Mailing Address - Phone:571-325-2983
Mailing Address - Fax:571-325-2982
Practice Address - Street 1:1850 TOWN CENTER PKWY, PAVILION 2
Practice Address - Street 2:STE 650
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190
Practice Address - Country:US
Practice Address - Phone:571-325-2983
Practice Address - Fax:571-325-2982
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3325207Q00000X
VA0101238983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG02815S01Medicare PIN