Organization
EXCEL MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHRIHARSH LAXMAN POLE (PRESIDENT)
(703) 497-4500
Entity
Organization
Contact information
Practice address
14904 JEFFERSON DAVIS HWY, SUITE 205, WOODBRIDGE, VA 22191-3908
(703) 497-4500
(703) 494-4671
Mailing address
14904 JEFFERSON DAVIS HWY, SUITE 205, WOODBRIDGE, VA 22191-3908
(703) 497-4500
(703) 494-4671
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0024166397
VA
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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