# VIP IMED CENTER

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

## Provider details

- **NPI number:** 1669804159
- **Authorized official:** VICTORIA BORISOVNA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (703) 207-4646

## Contact information

- **Practice address:** 8303 ARLINGTON BLVD, SUITE 110, FAIRFAX, VA 22031-4645
- **Practice address phone:** (703) 207-4646
- **Practice address fax:** (703) 563-7467
- **Mailing address:** 8303 ARLINGTON BLVD, SUITE 110, FAIRFAX, VA 22031-2903
- **Mailing address phone:** (703) 207-4646
- **Mailing address fax:** (703) 563-7467

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 0101255440 | VA | Yes |
| 208D00000X | General Practice Physician | 101055521 | VA | — |

## Other

- **Enumeration date:** 08/06/2013
- **Last updated:** 02/07/2014