Organization
MCLEAN DERMATOLOGY AND SKINCARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LILY TALAKOUB M.D. (OWNER)
(703) 356-5111
Entity
Organization
Contact information
Practice address
6849 OLD DOMINION DR, SUITE 340, MC LEAN, VA 22101-3724
(703) 356-5111
(703) 388-0873
Mailing address
PO BOX 9143, MC LEAN, VA 22102-0143
(703) 356-5111
(703) 388-0873
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
01012445533
VA
Other
Enumeration date
07/27/2010
Last updated
05/17/2013
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