Provider Demographics
NPI:1881740504
Name:ARLINGTON INTERNAL MEDICINE, P.C.
Entity type:Organization
Organization Name:ARLINGTON INTERNAL MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-522-1860
Mailing Address - Street 1:1624 N. GEORGE MASON DR
Mailing Address - Street 2:SUITE 434
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205
Mailing Address - Country:US
Mailing Address - Phone:703-522-1860
Mailing Address - Fax:703-522-7293
Practice Address - Street 1:1625 N GEORGE MASON DR
Practice Address - Street 2:SUITE 434
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3683
Practice Address - Country:US
Practice Address - Phone:703-522-1860
Practice Address - Fax:703-522-7293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00128Medicare PIN