Organization
BOSTON MEDICAL GROUP- VIRGINIA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM L. LE M.D. (MEDICAL DIRECTOR)
(818) 808-2828
Entity
Organization
Contact information
Practice address
4216 KING STREET, ALEXANDRIA, VA 22302
(703) 845-7411
(703) 845-7409
Mailing address
4216 KING STREET, ALEXANDRIA, VA 22302
(703) 845-7411
(703) 845-7409
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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