Organization
VIP IMED CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA BORISOVNA (EXECUTIVE DIRECTOR)
(703) 207-4646
Entity
Organization
Contact information
Practice address
8303 ARLINGTON BLVD, SUITE 110, FAIRFAX, VA 22031-4645
(703) 207-4646
(703) 563-7467
Mailing address
8303 ARLINGTON BLVD, SUITE 110, FAIRFAX, VA 22031-2903
(703) 207-4646
(703) 563-7467
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101255440
VA
208D00000X
General Practice Physician
101055521
VA
Other
Enumeration date
08/06/2013
Last updated
02/07/2014
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