Organization
IMAGE GUIDED SURGERY CENTER, LLC
Active
Other names
MCLEAN VEIN AND WELLNESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOURREDDINE GUAOUGUAOU MD (MEDICAL DIRECTOR)
(719) 955-9128
Entity
Organization
Contact information
Practice address
6723 WHITTIER AVE, MC LEAN, VA 22101-4522
(719) 955-9128
(866) 335-0887
Mailing address
6723 WHITTIER AVE, MC LEAN, VA 22101-4522
(719) 955-9128
(866) 335-0887
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
M60321
MD
Other
Enumeration date
09/14/2015
Last updated
09/14/2015
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