Provider Demographics
NPI:1104831510
Name:RIMICCI, ANTHONY JAMES (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JAMES
Last Name:RIMICCI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1635 N GEORGE MASON DR
Mailing Address - Street 2:#490
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3601
Mailing Address - Country:US
Mailing Address - Phone:703-522-5300
Mailing Address - Fax:703-908-0148
Practice Address - Street 1:1635 N GEORGE MASON DR
Practice Address - Street 2:#490
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3601
Practice Address - Country:US
Practice Address - Phone:703-522-5300
Practice Address - Fax:703-908-0148
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101232447207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
139530ZBRVOtherPTAN
139530ZBRVOtherPTAN