Provider Demographics
NPI:1871020651
Name:VIRGINIA INTERNAL MEDICINE SPECIALISTS LLC
Entity Type:Organization
Organization Name:VIRGINIA INTERNAL MEDICINE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAGIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-868-3011
Mailing Address - Street 1:44790 MAYNARD SQ STE 320
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6514
Mailing Address - Country:US
Mailing Address - Phone:571-206-8696
Mailing Address - Fax:
Practice Address - Street 1:44790 MAYNARD SQ STE 320
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6514
Practice Address - Country:US
Practice Address - Phone:571-206-8696
Practice Address - Fax:866-383-4386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101250130282N00000X, 310400000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No282N00000XHospitalsGeneral Acute Care Hospital
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility