POTOMAC INTERNAL MEDICINEPLLC NPI 1255565339

NPI Information

  • NPI: 1255565339
  • Provider Name: POTOMAC INTERNAL MEDICINE,PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 49D1101804
  • Address: 3985 PRINCE WILLIAM PKWY
    SUITE 102
    WOODBRIDGE, VA
    ZIP 22192
  • Phone: (703) 590-8375

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NPI Details

POTOMAC INTERNAL MEDICINE,PLLC is a family medicine in Woodbridge, VA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. POTOMAC INTERNAL MEDICINE,PLLC NPI is 1255565339. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3985 PRINCE WILLIAM PKWY
SUITE 102
WOODBRIDGE, VA
ZIP 22192-010
Phone: (703) 590-8375
Fax: (703) 590-8379

The provider's authorized official is Reza Golesorkhi .
The authorized official title is Owner and has the following contact phone number (703) 590-8375.

The CLIA number assigned to this NPI record is 49D1101804 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/5/2009 and was last updated on 5/5/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine0101233727VIRGINIAYes

What is NPI?

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This page was last updated on: 11/21/2025

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