Organization
MOUNT VERNON INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT HERRERA M.D. (PRESIDENT)
(703) 780-2800
Entity
Organization
Contact information
Practice address
6128 BRANDON AVE, SUITE 205, SPRINGFIELD, VA 22150-2640
(703) 780-2800
Mailing address
6128 BRANDON AVE, SUITE 205, SPRINGFIELD, VA 22150-2640
(703) 780-2800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198871
MEDICARE PTAN
VA
Enumeration date
03/18/2011
Last updated
03/18/2011
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