Healthcare Provider Details
I. General information
NPI: 1033520697
Provider Name (Legal Business Name): NORTHERN VIRGINIA PELVIC SURGERY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2014
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 IRVING ST NW WOMEN'S ONCOLOGY CENTER AND CANCER INSTITUTE
WASHINGTON DC
20010-3017
US
IV. Provider business mailing address
3289 WOODBURN RD SUITE 320
ANNANDALE VA
22003-6800
US
V. Phone/Fax
- Phone: 571-308-1830
- Fax: 571-308-1843
- Phone: 571-308-1830
- Fax: 571-308-1843
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANNETTE
BICHER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 571-308-1830