Great Falls Geriatric Medicine, Llc

LBN: Great Falls Geriatric Medicine, Llc
Great Falls Geriatric Medicine, Llc is an health care organization with primary practice located at 10017 Park Royal Dr , Great Falls VA 22066-1847. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as the primary health care specialty. Great Falls Geriatric Medicine, Llc can be contacted via phone (703) 947-7377, or through Martin, Carol Reyburn via phone (703) 947-7377.

Contact Information

Primary practice address
10017 Park Royal Dr Great Falls VA 22066-1847
Fax:
Website:
Authorized official contact:
Name: Martin, Carol Reyburn Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X

Profile Details

NPI number 1164019162
LBN Legal business name Great Falls Geriatric Medicine, Llc
DBA Doing business as
Authorized official Martin, Carol Reyburn Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 23rd, 2020
Last updated Dec 23rd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164019162 NPPES
Virginia Other 0101265405 MEDICAL LICENSE

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