Provider Demographics
NPI:1952426942
Name:FAMILY MEDICINE & ASSOCIATES OF ALEXANDRIA PC
Entity Type:Organization
Organization Name:FAMILY MEDICINE & ASSOCIATES OF ALEXANDRIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIRELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MIRCEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-370-2814
Mailing Address - Street 1:5249 DUKE ST
Mailing Address - Street 2:#100
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-2926
Mailing Address - Country:US
Mailing Address - Phone:703-370-2814
Mailing Address - Fax:703-370-7214
Practice Address - Street 1:5249 DUKE ST
Practice Address - Street 2:#100
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2926
Practice Address - Country:US
Practice Address - Phone:703-370-2814
Practice Address - Fax:703-370-7214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG00538Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER