Old Dominion Medical Center, P.c.

NPI #1104990167 in Mclean, Virginia

Provider Information

NPI Number: 1104990167
Entity Type: Organization
Organization Name: Old Dominion Medical Center, P.c.
Primary Specialty: Family Medicine
Enumeration Date: Nov 20, 2006
Last Updated: Feb 4, 2016

Practice Location

Address: 6715 WHITTIER AVENUE
Address 2: SUITE 100
City: Mclean
State: Virginia
ZIP Code: 22101
Phone: (703) 356-5700

Authorized Official

Name: DR. ALLEN BERNARD HORNE, M.D.
Title: PHYSICIAN OWNER
Phone: (703) 356-5700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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