Organization
CENTREVILLE INTERNAL MEDICINE
Active
Organization
CENTREVILLE INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUGKEE YOUN (DIRECTOR)
(703) 965-0180
Entity
Organization
Contact information
Practice address
13880 BRADDOCK RD STE 107, CENTREVILLE, VA 20121-2460
(703) 965-0180
(703) 266-9003
Mailing address
13880 BRADDOCK RD STE 107, CENTREVILLE, VA 20121-2460
(703) 965-0180
(703) 266-9003
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
0101235830
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010419719
—
VA
Enumeration date
07/16/2007
Last updated
08/09/2012
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