Image Guided Surgery Center, LLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

M60321 Issued in MD

Legal business name

IMAGE GUIDED SURGERY CENTER, LLC

Doing business as

MCLEAN VEIN AND WELLNESS CENTER

Practice address

6723 Whittier Ave
MC Lean, VA 22101-4522

Phone

(719) 955-9128

Fax

(866) 335-0887

NPI assigned

Sep 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Nourreddine Guaouguaou, MD

Title

Medical Director

Phone

(719) 955-9128

Specialties & licenses 1

Addresses

Other names 1

• MCLEAN VEIN AND WELLNESS CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nordine Gaugau, M.D.

  • Diagnostic Radiology Physician
  • MC Lean, VA
  • NPI 1134180300

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1285002808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6723 WHITTIER AVE",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014522",
            "telephone_number": "719-955-9128",
            "fax_number": "866-335-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6723 WHITTIER AVE",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014522",
            "telephone_number": "719-955-9128",
            "fax_number": "866-335-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE GUIDED SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "GUAOUGUAOU",
        "authorized_official_first_name": "NOURREDDINE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "719-955-9128",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MD",
            "license": "M60321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCLEAN VEIN AND WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aamir Naveed Hussain, MD
• Haroon Munawar Hussain, M.D.
• Olivia L Hutchinson
• Anne Huynh, PHARM D
• Elena Sophia Ifarraguerri
• Improved Dynamics ABA LLC
• Ineuroheadachespecialist
• Inspire Health IV LLC
• Integrated Psychology Associates of McLean, LLC
• Integrative Oral & Facial Surgery LLC

• Vascular & Interventional Radiology Physician in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Vascular & Interventional Radiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.