Organization
MEDI SLIM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWAN WONGVIAN (OWNER)
(804) 393-7538
Entity
Organization
Contact information
Practice address
4908 DOMINION BLVD, GLEN ALLEN, VA 23060-6774
(804) 393-7538
Mailing address
13604 SOVEREIGN CT, RICHMOND, VA 23233-7625
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/16/2026
Last updated
04/16/2026
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