Organization
LAKE RIDGE INTERNAL MEDICNE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASSAM FARAH MD (PRESIDENT)
(703) 492-1108
Entity
Organization
Contact information
Practice address
1725 FINANCIAL LOOP, WOODBRIDGE, VA 22192-2460
(703) 492-1108
Mailing address
1725 FINANCIAL LOOP, WOODBRIDGE, VA 22192-2460
(703) 492-1108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/18/2007
Last updated
04/16/2012
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