# CHANTILLY FAMILY MEDICINE LLC

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

## Provider details

- **NPI number:** 1306106182
- **Authorized official:** DR. KANIKA GOVIL M.D. (PRESIDENT)
- **Authorized official phone:** (703) 599-8463

## Contact information

- **Practice address:** 14113 ROBERT PARIS CT, CHANTILLY, VA 20151-4200
- **Practice address phone:** (703) 956-6757
- **Practice address fax:** (855) 359-2261
- **Mailing address:** 14113 ROBERT PARIS CT, CHANTILLY, VA 20151-4200
- **Mailing address phone:** (039) 566-7577
- **Mailing address fax:** (855) 359-2261

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101242454 | VA | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 05/25/2012
- **Last updated:** 08/31/2023