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Organization

FAMILY MEDICINE OF LAKE RIDGE PC

Active
Other names
Family Medicine of Lake Ridge
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GERRY A COPE MD (PHYSICIAN)
(703) 490-6265
Entity
Organization

Contact information

Practice address
3401 COMMISSION CT, STE 201, WOODBRIDGE, VA 22192
(703) 490-6265
(703) 490-6713
Mailing address
3401 COMMISSION CT, STE 201, WOODBRIDGE, VA 22192
(703) 490-6265
(703) 490-6713

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0024057411
VA
207Q00000X
Family Medicine Physician
0101039027
VA
207Q00000X
Family Medicine Physician
Primary
0101040586
VA

Other

Enumeration date
10/11/2006
Last updated
08/22/2020
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