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Organization

NORTHWEST INTERNISTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS M MASTERSON MD (DIRECTOR)
(703) 356-2037
Entity
Organization

Contact information

Practice address
1313 DOLLEY MADISON BLVD, SUITE 302, MC LEAN, VA 22101-3953
(703) 356-2037
(703) 734-8987
Mailing address
PO BOX 487, MC LEAN, VA 22101-0487
(703) 356-2037
(703) 734-8987

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101038350
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101038350
MEDICAL LICENSE
VA
Enumeration date
05/19/2006
Last updated
11/07/2007
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