Lorton Primary Care Plc

NPI #1487942793 in Lorton, Virginia

Provider Information

NPI Number
1487942793
Entity Type
Organization
Organization Name
Lorton Primary Care Plc
Primary Specialty
Pediatrics
Enumeration Date
Jul 20, 2011
Last Updated
Jul 20, 2011

Practice Location

Address
7740 GUNSTON PLZ
City
Lorton
ZIP Code
22079-1897
Phone
(703) 339-5858

Authorized Official

Name
MAKONNEN K ZELLEKE, M.D.
Title
PRESIDENT/CEO
Phone
(703) 339-5858

Specialties & Taxonomy Codes

Specialty
Internal Medicine
Pediatrics

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