Organization
NORTH VIRGINIA FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TEJAS J SHAH M.D. (DIRECTOR, CEO)
(703) 580-0124
Entity
Organization
Contact information
Practice address
4331 RIDGEWOOD CENTER DR, WOODBRIDGE, VA 22192-5308
(703) 580-0124
(703) 580-0126
Mailing address
4331 RIDGEWOOD CENTER DR, WOODBRIDGE, VA 22192-5308
(703) 580-0124
(703) 580-0126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101235482
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010093139
—
VA
Enumeration date
07/21/2008
Last updated
07/21/2008
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