Provider Demographics
NPI:1992954630
Name:VIRGINIA HEALTH CENTER PC
Entity type:Organization
Organization Name:VIRGINIA HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSTAFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-333-5288
Mailing Address - Street 1:6400 ARLINGTON BLVD
Mailing Address - Street 2:SUITE NUMBER 940
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2325
Mailing Address - Country:US
Mailing Address - Phone:703-532-4124
Mailing Address - Fax:
Practice Address - Street 1:6400 ARLINGTON BLVD
Practice Address - Street 2:SUITE 940
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2336
Practice Address - Country:US
Practice Address - Phone:703-532-4124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRGINIA HEALTH CENTER PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204086174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty