Organization
PREM P. MANCHANDA MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PREM MANCHANDA M.D. (OWNER)
(703) 981-4865
Entity
Organization
Contact information
Practice address
4660 KENMORE AVE, 220, ALEXANDRIA, VA 22304-1313
(703) 981-4865
Mailing address
4100 ORCHARD DR, FAIRFAX, VA 22032-1021
(703) 981-4865
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101057630
VA
Other
Enumeration date
05/17/2011
Last updated
11/23/2011
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