Organization
LIFESTYLE PHYSICIANS LLC
Active
Parent organization
LIFESTYLE PHYSICIANS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFESTYLE PHYSICIANS LLC
Authorized official
SAGAR VERMA (MD)
(540) 829-5773
Entity
Organization
Contact information
Practice address
12330 PINECREST RD STE 125, RESTON, VA 20191-1655
(540) 680-2426
Mailing address
147 ALEXANDRIA PIKE STE 104, WARRENTON, VA 20186-2947
(540) 680-2426
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101253031
STATE LICENSE
VA
Enumeration date
02/26/2020
Last updated
02/26/2020
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