Provider Demographics
NPI:1972026698
Name:SIMPLYSLIM MEDICAL OF VIRGINIA
Entity Type:Organization
Organization Name:SIMPLYSLIM MEDICAL OF VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-997-1220
Mailing Address - Street 1:7700 LEESBURG PIKE STE 108
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2618
Mailing Address - Country:US
Mailing Address - Phone:703-997-1220
Mailing Address - Fax:301-658-2019
Practice Address - Street 1:7700 LEESBURG PIKE
Practice Address - Street 2:STE 108
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2618
Practice Address - Country:US
Practice Address - Phone:703-997-1220
Practice Address - Fax:301-658-2019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0224000448261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty