Individual
DR. JERRY ANTHONY OMELON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 OLD CHAIN BRIDGE RD, SUITE 101, MCLEAN, VA 22101-3955
(703) 893-2273
(703) 893-4559
Mailing address
1340 OLD CHAIN BRIDGE RD, SUITE 101, MCLEAN, VA 22101-3955
(703) 893-2273
(703) 893-4559
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101050531
VA
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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