Provider Demographics
NPI:1275263790
Name:BE WELL FAMILY MEDICINE AND WELLNESS CENTER, PLLC
Entity Type:Organization
Organization Name:BE WELL FAMILY MEDICINE AND WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMINAH
Authorized Official - Middle Name:LATONYA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-593-5103
Mailing Address - Street 1:18000 RED CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2943
Mailing Address - Country:US
Mailing Address - Phone:703-593-5103
Mailing Address - Fax:
Practice Address - Street 1:3779 FETTLER PARK DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-1946
Practice Address - Country:US
Practice Address - Phone:571-391-6727
Practice Address - Fax:703-291-7129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty