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INTEGRATED WELLNESS MD, LLC

Physicians Family Medicine

Provider NPI: 1720448442

Organization Information:
Organization Name:  INTEGRATED WELLNESS MD, LLC
Organization is not Subpart
Authorized Official:  CARL DOUGLAS LORD  OWNER  301-502-5566

Practice Location:
8316 ARLINGTON BLVD STE 206  FAIRFAX, VA 22031-5216 US
Tel: 800-762-6282  Fax: --

Business Mailing Address:
9755 PATUXENT WOODS DR STE 100 COLUMBIA, MD 21046-2286 US
Tel: --  Fax: --

NPI Information:
NPI: 1720448442
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207Q00000XPhysicians
Family Medicine
N207R00000XPhysicians
Internal Medicine
N207VG0400XPhysicians
Obstetrics & Gynecology
N207VX0000XPhysicians
Obstetrics & Gynecology
N363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
N363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
N363LG0600XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Y207V00000XPhysicians
Obstetrics & Gynecology

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 207V00000X

Type:

Classification:



Definition:



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