| Organization Name: | INTERNATIONAL MEDICAL CENTER, INC |
| NPI Number: | 1265685515 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EUN HEE LEE (PRESIDENT) |
| Mailing Address: | 5410 Port Royal Rd Suite 100 Springfield |
| State: | VA US |
| Postal Code: | 221512314 |
| Phone Number: | 7036421004 |
| Fax Number: | 7036423232 |
| NPI Enumeration Date: | 10/30/2008 |
| NPI Last Update Date: | 10/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 101052584 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |