# NOVA PHYSICIAN WELLNESS CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215307400
- **Authorized official:** ROHIT SURI MD (OWNER)
- **Authorized official phone:** (703) 865-6490

## Contact information

- **Practice address:** 3903 FAIR RIDGE DR, SUITE 219, FAIRFAX, VA 22033-2943
- **Practice address phone:** (703) 865-6490
- **Practice address fax:** (703) 865-6492
- **Mailing address:** 4211 FAIRFAX CORNER AVE E, SUITE 200, FAIRFAX, VA 22030-8622
- **Mailing address phone:** (703) 865-6490
- **Mailing address fax:** (703) 865-6492

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/30/2015
- **Last updated:** 09/30/2015