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Organization
SUDLEY MEDICAL CLINIC INC
Active
Organization
SUDLEY MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA E MENDOZA (OFFICE MANAGER)
(703) 626-7501
Entity
Organization
Contact information
Practice address
10757 AMBASSADOR DR, SUITE 101, MANASSAS, VA 20109-2522
(703) 626-7501
(571) 379-7468
Mailing address
10757 AMBASSADOR DR, SUITE 101, MANASSAS, VA 20109-2522
(703) 626-7501
(571) 379-7468
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101239873
VA
Other
Enumeration date
01/28/2011
Last updated
09/28/2012
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