Organization
DULLES MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANIL J PATEL M.D. (PRESIDENT)
(703) 777-8840
Entity
Organization
Contact information
Practice address
224D CORNWALL ST NW, SUITE 303, LEESBURG, VA 20176-2700
(703) 777-8840
(703) 779-0887
Mailing address
224D CORNWALL ST NW, SUITE 303, LEESBURG, VA 20176-2700
(703) 777-8840
(703) 779-0887
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
0101045895
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005842875
—
VA
01
—
070317
BLUECROSS BLUESHIELD
VA
01
—
A840-001
CAREFIRST
VA
Enumeration date
10/06/2006
Last updated
01/15/2009
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