Organization
THE MEDICAL CLINIC
Active
Parent organization
THE MEDICAL CLINIC
Other names
Center for Vein Restoration
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE MEDICAL CLINIC
Authorized official
SANJIV LAKHANPAL MD (PRESIDENT)
(240) 460-1073
Entity
Organization
Contact information
Practice address
4217 EVERGREEN LN, ANNANDALE, VA 22003-3210
(301) 886-8363
(301) 441-8806
Mailing address
12200 ANNAPOLIS RD, STE 225, GLENN DALE, MD 20769-9182
(301) 860-0930
(301) 809-0929
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0053733
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
893L
MEDICARE ID
MD
01
—
G00397
MEDICARE ID
DC
Enumeration date
02/03/2010
Last updated
04/05/2010
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