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
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