Provider Demographics
NPI:1073971610
Name:PULMONARY CENTER OF NORTHERN VIRGINIA PLLC
Entity Type:Organization
Organization Name:PULMONARY CENTER OF NORTHERN VIRGINIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SWAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-542-8884
Mailing Address - Street 1:24585 STONE CARVER DRIVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-2798
Mailing Address - Country:US
Mailing Address - Phone:703-542-8884
Mailing Address - Fax:571-367-4833
Practice Address - Street 1:24585 STONE CARVER DRIVE STE 100
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-2798
Practice Address - Country:US
Practice Address - Phone:703-542-8884
Practice Address - Fax:571-367-4833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
VA0101250738207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF908Medicare UPIN
DC501403Medicare UPIN