Provider Demographics
NPI:1497927537
Name:W JAMES WERNER MD FAMILY MEDICINE PLC
Entity Type:Organization
Organization Name:W JAMES WERNER MD FAMILY MEDICINE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:W
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-361-3161
Mailing Address - Street 1:8575 SUDLEY RD
Mailing Address - Street 2:SUITE A & B
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-3861
Mailing Address - Country:US
Mailing Address - Phone:703-361-3161
Mailing Address - Fax:703-361-1529
Practice Address - Street 1:8575 SUDLEY RD
Practice Address - Street 2:SUITE A & B
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-3861
Practice Address - Country:US
Practice Address - Phone:703-361-3161
Practice Address - Fax:703-361-1529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101022805174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08162Medicare PIN