Organization
NORTHERN VIRGINIA RADIOLOGY AND NUCLEAR MEDICINE,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PANOS G KOUTROUVELIS M.D. (PRESIDENT)
(703) 356-9674
Entity
Organization
Contact information
Practice address
8320 OLD COURTHOUSE RD, #150, VIENNA, VA 22182-3831
(703) 356-9674
(703) 356-9589
Mailing address
8320 OLD COURTHOUSE RD, #150, VIENNA, VA 22182-3831
(703) 356-9674
(703) 356-9589
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039101
ANTHEM
VA
05
—
7204876
—
VA
01
—
7857
CAREFIRST
VA
Enumeration date
04/11/2007
Last updated
08/22/2020
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