Provider Demographics
NPI:1538985379
Name:VIRGINIA INTEGRATED PRIMARY CARE AND WEIGHT LOSS CENTER LLC
Entity type:Organization
Organization Name:VIRGINIA INTEGRATED PRIMARY CARE AND WEIGHT LOSS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMDANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-212-9217
Mailing Address - Street 1:PO BOX 11768
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-0168
Mailing Address - Country:US
Mailing Address - Phone:804-281-3319
Mailing Address - Fax:
Practice Address - Street 1:1455 JOHNSTON WILLIS DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4730
Practice Address - Country:US
Practice Address - Phone:804-537-8472
Practice Address - Fax:804-537-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty