Provider Demographics
NPI:1295025021
Name:INTERNAL MEDICINE PRACTICE FOR WEIGHT LOSS AND SMOKERS PC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE PRACTICE FOR WEIGHT LOSS AND SMOKERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:HSIAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-256-1335
Mailing Address - Street 1:7501 LITTLE RIVER TPKE STE 103
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2923
Mailing Address - Country:US
Mailing Address - Phone:703-256-1335
Mailing Address - Fax:
Practice Address - Street 1:7501 LITTLE RIVER TPKE STE 103
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2923
Practice Address - Country:US
Practice Address - Phone:703-256-1335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051072207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty