Organization
MILLENNIUM MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAYMA AL-MUDHAFAR MD (PRESIDENT)
(703) 820-7520
Entity
Organization
Contact information
Practice address
3606 FOREST DR, ALEXANDRIA, VA 22302-1005
(703) 820-7520
Mailing address
3606 FOREST DR, ALEXANDRIA, VA 22302-1005
(703) 820-7520
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101242652
VA
Other
Enumeration date
10/06/2009
Last updated
10/06/2009
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