Organization
CARE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIRAV K THAKKAR M.D. (OWNER)
(502) 212-9393
Entity
Organization
Contact information
Practice address
25303 GOTHIC SQ, CHANTILLY, VA 20152-4104
(703) 396-5292
(703) 396-5297
Mailing address
25303 GOTHIC SQ, CHANTILLY, VA 20152-4104
(703) 396-5292
(703) 396-5297
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101252586
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101252586
VA LICENSE
VA
Enumeration date
04/15/2014
Last updated
04/15/2014
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