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HEALTH CONNECT IPA

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1932447463

Organizational Registrant:
Organization Name:  HEALTH CONNECT IPA
Organization is not Subpart
Authorized Official:  LAURI  RUSTAND  EXECUTIVE DIRECTOR  703--39-12042

Location and contact information for practice:
12011 LEE JACKSON MEMORIAL HWY SUITE 504 FAIRFAX, VA 22033-3310 US
Tel: 703-391-2042  Fax: 703-273-3943

Contact information for business:
12011 LEE JACKSON MEMORIAL HWY SUITE 504 FAIRFAX, VA 22033-3310 US
Tel: 703-391-2042  Fax: 703-273-3943

Registration Information:
NPI: 1932447463
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
N208000000XAllopathic & Osteopathic Physicians
Pediatrics
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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