Provider Demographics
NPI:1740828953
Name:ALEXANDRIA INTERNAL MEDICINE OF NORTHERN VIRGINIA PC
Entity type:Organization
Organization Name:ALEXANDRIA INTERNAL MEDICINE OF NORTHERN VIRGINIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:GEHRING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-888-8448
Mailing Address - Street 1:4660 KENMORE AVE STE 604
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1300
Mailing Address - Country:US
Mailing Address - Phone:703-823-8300
Mailing Address - Fax:703-823-5532
Practice Address - Street 1:4660 KENMORE AVE STE 604
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1300
Practice Address - Country:US
Practice Address - Phone:703-823-8300
Practice Address - Fax:703-823-5532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty