Provider Demographics
NPI:1487189247
Name:ARLINGTON MEDICAL GROUP P C
Entity Type:Organization
Organization Name:ARLINGTON MEDICAL GROUP P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:BORGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-522-7444
Mailing Address - Street 1:1635 N GEORGE MASON DR
Mailing Address - Street 2:SUITE 480
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3601
Mailing Address - Country:US
Mailing Address - Phone:703-522-7444
Mailing Address - Fax:703-522-1598
Practice Address - Street 1:1635 N GEORGE MASON DR
Practice Address - Street 2:SUITE 480
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3601
Practice Address - Country:US
Practice Address - Phone:703-522-7444
Practice Address - Fax:703-522-1598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040132261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6030807Medicaid
VAC87830Medicare UPIN
VA6030807Medicaid