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Organization

SHILOH FAMILY MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRADLEY RICHARD WARE M.D. (PRESIDENT/CEO)
(703) 823-3660
Entity
Organization

Contact information

Practice address
5249 DUKE ST, SUITE 102, ALEXANDRIA, VA 22304-2926
(703) 823-3660
(703) 823-2210
Mailing address
5249 DUKE ST, SUITE 102, ALEXANDRIA, VA 22304-2926
(703) 823-3660
(703) 823-2210

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
0101050807
VA

Other

Enumeration date
10/18/2006
Last updated
08/22/2020
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