# CENTREVILLE MEDICAL PRACTICE PLLC

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

## Provider details

- **NPI number:** 1659675460
- **Authorized official:** DR. NASIR RAMIN M.D. (OWNER)
- **Authorized official phone:** (703) 631-5151

## Contact information

- **Practice address:** 5715 CENTRE SQUARE DR, CENTREVILLE, VA 20120-1916
- **Practice address phone:** (703) 631-5151
- **Practice address fax:** (703) 631-9754
- **Mailing address:** 5715 CENTRE SQUARE DR, CENTREVILLE, VA 20120-1916
- **Mailing address phone:** (703) 631-5151
- **Mailing address fax:** (703) 631-9754

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101248485 | VA | Yes |

## Other

- **Enumeration date:** 01/08/2011
- **Last updated:** 01/08/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1144388794 | NPI OF DR. NASIR RAMIN | — |