Organization
PRIMARY CARE ASSOCIATES OF POTOMAC PC
Active
Organization
PRIMARY CARE ASSOCIATES OF POTOMAC PC
Active
Other names
Primary Care Assoc of Potomac PC
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN H WYNN MD (PRESIDENT)
(703) 490-3997
Entity
Organization
Contact information
Practice address
1900 OPITZ BLVD, SUITE F, WOODBRIDGE, VA 22191
(703) 490-3997
(703) 491-3376
Mailing address
1900 OPITZ BLVD, SUITE F, WOODBRIDGE, VA 22191
(703) 490-3997
(703) 491-3376
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101040884
VA
207R00000X
Internal Medicine Physician
0101239629
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006064043
—
VA
Enumeration date
07/07/2005
Last updated
05/05/2008
Update your record
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