Provider Demographics
NPI:1609189414
Name:PHYSICIANS OFFICE
Entity Type:Organization
Organization Name:PHYSICIANS OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-765-6222
Mailing Address - Street 1:6641 WAKEFIELD DR STE 108
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-6859
Mailing Address - Country:US
Mailing Address - Phone:703-765-6222
Mailing Address - Fax:703-765-4554
Practice Address - Street 1:6641 WAKEFIELD DR STE 108
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22307-6859
Practice Address - Country:US
Practice Address - Phone:703-765-6222
Practice Address - Fax:703-765-4554
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIANS OFFICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101023815282N00000X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6054081Medicaid
VA6054081Medicaid