Organization
NOVA RECONSTRUCTIVE AND COSMETIC SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARWAN KHALIFEH (MEMBER)
(202) 486-2261
Entity
Organization
Contact information
Practice address
8180 GREENSBORO DR, #1015, MC LEAN, VA 22102-3888
(703) 543-9252
Mailing address
8180 GREENSBORO DR, #1015, MC LEAN, VA 22102-3888
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101240322
VA
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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