Organization
METHUSELAH FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL RAYES ESQ. (ATTORNEY)
(818) 321-8568
Entity
Organization
Contact information
Practice address
8021 FLINT ST, SPRINGFIELD, VA 22153-2438
(818) 321-8568
Mailing address
8021 FLINT ST, SPRINGFIELD, VA 22153-2438
(818) 321-8568
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
09/16/2024
Last updated
09/17/2024
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