Provider Demographics
NPI:1053930024
Name:VIRGINIA FAMILY INTEGRATED MEDICINE LP
Entity type:Organization
Organization Name:VIRGINIA FAMILY INTEGRATED MEDICINE LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:HATAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-370-5300
Mailing Address - Street 1:50 S PICKETT ST STE 114
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-7206
Mailing Address - Country:US
Mailing Address - Phone:703-370-5300
Mailing Address - Fax:
Practice Address - Street 1:50 S PICKETT ST STE 114
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-7206
Practice Address - Country:US
Practice Address - Phone:703-370-5300
Practice Address - Fax:703-370-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty