Provider Demographics
NPI:1497936017
Name:QUALITY INTERNAL MEDICINE, PLLC
Entity Type:Organization
Organization Name:QUALITY INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE ROSE
Authorized Official - Middle Name:NAVARRO
Authorized Official - Last Name:EAPEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-855-1119
Mailing Address - Street 1:1860 TOWN CENTER DRIVE
Mailing Address - Street 2:SUITE 255
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5906
Mailing Address - Country:US
Mailing Address - Phone:703-707-0607
Mailing Address - Fax:703-707-0949
Practice Address - Street 1:1860 TOWN CENTER DRIVE
Practice Address - Street 2:SUITE 255
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5906
Practice Address - Country:US
Practice Address - Phone:703-707-0607
Practice Address - Fax:703-707-0949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101045101207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA570451OtherCIGNA
VAEA 602956Medicare PIN
VA570451OtherCIGNA