Organization
ONE HEALTH MEDICAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MINGLIARTI TJAHJANA MD (OWNER/CEO)
(571) 572-9198
Entity
Organization
Contact information
Practice address
1850 TOWN CENTER DRIVE, SUITE 410, RESTON, VA 20190-3219
(571) 572-9054
(571) 482-6080
Mailing address
1850 TOWN CENTER DRIVE, SUITE 410, RESTON, VA 20190-3219
(571) 572-9054
(571) 482-6080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101236144
VA
Other
Enumeration date
05/08/2017
Last updated
05/08/2017
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