Provider Demographics
NPI:1225193311
Name:VIENNA INTERNAL MEDICINE ASSOCIATES PC
Entity Type:Organization
Organization Name:VIENNA INTERNAL MEDICINE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIBOR
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-938-7800
Mailing Address - Street 1:135 CENTER ST S
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-5720
Mailing Address - Country:US
Mailing Address - Phone:703-938-7800
Mailing Address - Fax:
Practice Address - Street 1:135 CENTER ST S
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5720
Practice Address - Country:US
Practice Address - Phone:703-938-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty