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Organization

NORTHERN VIRGINIA NEPHROLOGY ASSOCIATES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAGNUS K IKHINMWIN MD (MEDICAL DIRECTOR)
(703) 204-1614
Entity
Organization

Contact information

Practice address
3650 JOSEPH SIEWICK DR STE 310, FAIRFAX, VA 22033-1715
(703) 758-8800
(703) 758-9500
Mailing address
10882 MIMOSA PLACE, OAKTON, VA 22124
(703) 204-1614
(703) 204-1826

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
0101057344
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005856141
VA
01
00B485N64
DC MEDICARE
DC
01
00V069N17
VA MEDICARE
01
08492993A
GEORGIA MEDICAID
01
1102268673
MEDICARE RAILROAD
01
1121069
FIRST HEALTH
01
2614802
AETNA HMO
01
279891
AMERIGROUP
01
289502
ALLIANCE PPO
01
319481
ANTHEM
01
391480
ANTHEM
01
41838
GWU HP
01
490807
MEDICARE
01
5402030870
AARP UNITED HEALTHCARE
01
5972317
AETNA PPO
01
8989317
CIGNA
01
9458135
CALIFORNIA MEDICAID
01
F078 0001
BC CAREFIRST
01
XYPLA8274
CALIFORNIA MEDICAID
Enumeration date
01/09/2007
Last updated
12/21/2023
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