Provider Demographics
NPI:1205623808
Name:NORTHERN VIRGINIA MEDICAL CENTER
Entity type:Organization
Organization Name:NORTHERN VIRGINIA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-533-0311
Mailing Address - Street 1:6400 ARLINGTON BLVD STE 910
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2336
Mailing Address - Country:US
Mailing Address - Phone:703-533-0311
Mailing Address - Fax:
Practice Address - Street 1:6400 ARLINGTON BLVD STE 910
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2336
Practice Address - Country:US
Practice Address - Phone:703-533-0311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care