Provider Demographics
NPI:1134669211
Name:LIFESTYLE PHYSICIANS LLC
Entity Type:Organization
Organization Name:LIFESTYLE PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-883-7837
Mailing Address - Street 1:147 ALEXANDRIA PIKE STE 104
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2947
Mailing Address - Country:US
Mailing Address - Phone:866-883-7837
Mailing Address - Fax:
Practice Address - Street 1:147 ALEXANDRIA PIKE STE 104
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2947
Practice Address - Country:US
Practice Address - Phone:866-883-7837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101253031207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty