Provider Demographics
NPI:1598885519
Name:STATHEALTH MEDICAL CENTERS INC
Entity Type:Organization
Organization Name:STATHEALTH MEDICAL CENTERS INC
Other - Org Name:FAMILY MEDICINE AT LANSDOWNE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-726-8687
Mailing Address - Street 1:19450 DEERFIELD AVE
Mailing Address - Street 2:SUITE 265
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6820
Mailing Address - Country:US
Mailing Address - Phone:703-726-8687
Mailing Address - Fax:703-726-0081
Practice Address - Street 1:19450 DEERFIELD AVE
Practice Address - Street 2:SUITE 265
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-726-8687
Practice Address - Fax:703-726-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-31
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235372261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
$$$$$$$$$OtherSSN
VA1194729970OtherNPI