Organization
ELITE MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED AZIM MD (PRESIDENT)
(555) 555-1212
Entity
Organization
Contact information
Practice address
8420 QUARRY RD, MANASSAS, VA 20110-5326
(571) 208-1965
Mailing address
8420 QUARRY RD, MANASSAS, VA 20110-5326
(571) 208-1965
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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