Organization
FAIRFAX CARDIAC IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THIENQUANG DAT LE M.D. (MANAGING PARTNER)
(703) 716-5404
Entity
Organization
Contact information
Practice address
3700 JOSEPH SIEWICK DR, SUITE 402, FAIRFAX, VA 22033-1744
(703) 716-5404
(703) 716-5410
Mailing address
3700 JOSEPH SIEWICK DR, SUITE 402, FAIRFAX, VA 22033-1744
(703) 716-5404
(703) 716-5410
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
MD-03-111-01
MD
Other
Enumeration date
08/11/2007
Last updated
08/11/2007
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