Provider Demographics
NPI:1356114474
Name:PARKTOWN MEDICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:PARKTOWN MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:MAWESA
Authorized Official - Last Name:DIOMI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:703-424-9911
Mailing Address - Street 1:10076 DUMFRIES RD STE 80A
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-7949
Mailing Address - Country:US
Mailing Address - Phone:703-424-9911
Mailing Address - Fax:888-814-0934
Practice Address - Street 1:10076 DUMFRIES RD STE 80A
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-7949
Practice Address - Country:US
Practice Address - Phone:703-424-9911
Practice Address - Fax:888-814-0934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty