| Organization Name: | DULLES URGENT CARE CENTER LLC |
| NPI Number: | 1881716363 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANITA S CHATMAN (MEDICAL DIRECTOR) |
| Mailing Address: | 42010 Village Center Plz Suite # 100 Stone Ridge |
| State: | VA US |
| Postal Code: | 201053032 |
| Phone Number: | 7035427921 |
| Fax Number: | 7035427931 |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 09/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |