Provider Demographics
NPI:1790732667
Name:THE MEDICAL TEAM, INC
Entity Type:Organization
Organization Name:THE MEDICAL TEAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-390-2300
Mailing Address - Street 1:1902 CAMPUS COMMONS DR
Mailing Address - Street 2:SUITE 650
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1563
Mailing Address - Country:US
Mailing Address - Phone:703-390-2300
Mailing Address - Fax:703-390-5819
Practice Address - Street 1:1896 PRESTON WHITE DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-4325
Practice Address - Country:US
Practice Address - Phone:703-390-2300
Practice Address - Fax:703-390-5819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004970331Medicaid
VA497033Medicare Oscar/Certification