Provider Demographics
NPI:1457682189
Name:ONE CARE MEDICAL
Entity Type:Organization
Organization Name:ONE CARE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-308-8530
Mailing Address - Street 1:13895 HEDGEWOOD DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-7925
Mailing Address - Country:US
Mailing Address - Phone:571-308-8530
Mailing Address - Fax:425-905-1813
Practice Address - Street 1:13895 HEDGEWOOD DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-7924
Practice Address - Country:US
Practice Address - Phone:571-308-8530
Practice Address - Fax:425-905-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246283207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty