Provider Demographics
NPI:1013028182
Name:INTERNAL MEDICINE ASSOCIATES OF NORTHERN VIRGINIA, LTD
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF NORTHERN VIRGINIA, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:R,
Authorized Official - Last Name:VOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-451-4524
Mailing Address - Street 1:6128 BRANDON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2693
Mailing Address - Country:US
Mailing Address - Phone:703-451-4524
Mailing Address - Fax:703-451-3950
Practice Address - Street 1:6128 BRANDON AVE STE 201
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2693
Practice Address - Country:US
Practice Address - Phone:703-451-4524
Practice Address - Fax:703-451-3950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101018446207R00000X
VA0101027461207R00000X
VA0101057797207R00000X
VA0101041300207RG0100X
VA0101035942207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C61761Medicare UPIN
D45613Medicare UPIN
C89052Medicare UPIN
KA847935Medicare ID - Type UnspecifiedDR. ERNEST KATZ, III
G98845Medicare UPIN
C61786Medicare UPIN
GA76430Medicare ID - Type UnspecifiedDR. ALLEN GARDNER
VO438284Medicare ID - Type UnspecifiedDR. STEPHEN VOSS
MU81638Medicare ID - Type UnspecifiedDR. RAYMOND MUROW