# NORTH VIRGINIA FAMILY PRACTICE PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1417112236
- **Authorized official:** DR. TEJAS J SHAH M.D. (DIRECTOR, CEO)
- **Authorized official phone:** (703) 580-0124

## Contact information

- **Practice address:** 4331 RIDGEWOOD CENTER DR, WOODBRIDGE, VA 22192-5308
- **Practice address phone:** (703) 580-0124
- **Practice address fax:** (703) 580-0126
- **Mailing address:** 4331 RIDGEWOOD CENTER DR, WOODBRIDGE, VA 22192-5308
- **Mailing address phone:** (703) 580-0124
- **Mailing address fax:** (703) 580-0126

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101235482 | VA | Yes |

## Other

- **Enumeration date:** 07/21/2008
- **Last updated:** 07/21/2008