Organization
FAMILY IMMEDIATE CARE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHETPAILIN AMARALIKIT M.D. (PRESIDENT)
(571) 218-5788
Entity
Organization
Contact information
Practice address
420 ELDEN ST, HERNDON, VA 20170-4511
(571) 218-5788
Mailing address
9429 WINTERSET DR, POTOMAC, MD 20854-2845
(571) 218-5788
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101244099
VA
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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