| Organization Name: | MADISON FAMILY MEDICINE, PC |
| NPI Number: | 1023252624 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HAMID S ASSADI (PRESIDENT) |
| Mailing Address: | 2555 Chain Bridge Rd Vienna |
| State: | VA US |
| Postal Code: | 22181 |
| Phone Number: | 7032616550 |
| Fax Number: | 7032616279 |
| NPI Enumeration Date: | 04/27/2009 |
| NPI Last Update Date: | 04/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 0101242970 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |