Anita N. Wasan MD PLC
Organization Active NPI Clinic/Center · MC Lean, VA
NPI 1487101440 · NPPES record last updated Sep 7, 2016
Key facts
- NPI
- 1487101440
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 0101237864 (VA)
- Legal business name
- ANITA N. WASAN MD PLC
- Practice address
- 8115 Old Dominion Dr
Ste 220
MC Lean, VA 22102-2325 - Phone
- (703) 992-7065
- Fax
- (703) 992-7063
- NPI assigned
- Sep 7, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Anita N Wasan, MD
- Title
- Owner
- Phone
- (703) 992-7065
Practitioners 2
-
Amy Feldman, PA-C
-
Anita Nanda Wasan, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200113002474 | DC | Part B Supplier - Clinic/Group Practice | 2163455924 |
Receives reassigned benefits from 2 practitioners Practice locations: MC Lean, VA |
National Provider Directory
Locations
8115 Old Dominion Dr
Ste 220
Mc Lean, VA 22102
Phone (703) 992-7065
6824 Elm St
Mc Lean, VA 22101
6824 Elm St
Ste 120
McLean, VA 22101
Phone (703) 992-7065
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 0101237864 | VA | Yes |
Addresses
Primary practice location
8115 Old Dominion Dr
Ste 220
MC Lean, VA 22102-2325
Mailing address
8115 Old Dominion Dr
Ste 220
MC Lean, VA 22102-2325
Phone (703) 992-7065
Other names
- Allergy and Asthma Center
Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.