Potomac Internal Medicine,PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101233727 Issued in VA

Legal business name

POTOMAC INTERNAL MEDICINE,PLLC

Practice address

3985 Prince William Pkwy
Suite 102
Woodbridge, VA 22192-5010

Phone

(703) 590-8375

Fax

(703) 590-8379

NPI assigned

May 5, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Reza Golesorkhi, M.D.

Title

Owner

Phone

(703) 590-8375

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1255565339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3985 PRINCE WILLIAM PKWY",
            "address_2": "SUITE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925010",
            "telephone_number": "703-590-8375",
            "fax_number": "703-590-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3985 PRINCE WILLIAM PKWY",
            "address_2": "SUITE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925010",
            "telephone_number": "703-590-8375",
            "fax_number": "703-590-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC INTERNAL MEDICINE,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A",
        "authorized_official_last_name": "GOLESORKHI",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-590-8375",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101233727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Potomac Hospital Corporation of Prince William
• Potomac Hospital Corporation of Prince William
• Potomac Inova Healthcare Alliance
• Potomac Inova Healthcare Alliance, LLC
• Potomac Inova Healthcare Alliance, LLC
• Potomac Mills Family Dental
• Potomac Ophthalmology PC
• Potomac Orthodontics PLLC
• Potomac Pathology PLLC
• Potomac Pediatrics, P.C.

• Family Medicine Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.