Basic Information
| Provider Information | |||||||||
| NPI: | 1326138272 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FALLS CHURCH FAMILY CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6712 ARLINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | FALLS CHURCH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7035348007 | ||||||||
| FaxNumber: | 3019349321 | ||||||||
| Practice Location | |||||||||
| Address1: | 6712 ARLINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | FALLS CHURCH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7035348007 | ||||||||
| FaxNumber: | 3019349321 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 02/06/2008 | ||||||||
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| AuthorizedOfficialLastName: | CHEEMA | ||||||||
| AuthorizedOfficialFirstName: | ARSHAD | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7035348007 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101057266 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 5633346 | 05 | VA | MEDICAID | P00213535 | 01 | VA | RAILROAD MEDICARE | OTHER |