Provider Demographics
NPI:1871370247
Name:BELTWAY MEDICAL GROUP
Entity type:Organization
Organization Name:BELTWAY MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAUGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-459-7759
Mailing Address - Street 1:12011 ROUTE 50 STE 103
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-3323
Mailing Address - Country:US
Mailing Address - Phone:703-232-2524
Mailing Address - Fax:571-340-3304
Practice Address - Street 1:12011 ROUTE 50 STE 103
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-3323
Practice Address - Country:US
Practice Address - Phone:703-232-2524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty