Provider Demographics
NPI:1861228660
Name:ALTMED MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:ALTMED MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MADHUSUDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-485-2000
Mailing Address - Street 1:8551 RIXLEW LN STE 140
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-4278
Mailing Address - Country:US
Mailing Address - Phone:703-361-4357
Mailing Address - Fax:703-361-0346
Practice Address - Street 1:8551 RIXLEW LN STE 140
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-4278
Practice Address - Country:US
Practice Address - Phone:703-361-4357
Practice Address - Fax:703-361-0346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty