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Contact Information

INTEGRATIVE MEDICINE & WELLNESS
42029 BUSHCLOVER TERRACE
ALDIE, VA20105
 Phone: 571-659-4316
 Fax: 866-611-2705
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for INTEGRATIVE MEDICINE & WELLNESS

NPI # 1386423804
LBN Legal business name INTEGRATIVE MEDICINE & WELLNESS
Authorized official MARIYA BOURGET - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/25/2023
Last updated 09/25/2023 - About 3 years ago
Identifiers
VA Medicaid VV1662B
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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