Healthcare Provider Details

I. General information

NPI: 1992617088
Provider Name (Legal Business Name): THE CARDIOVASCULAR GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4825 MARK CENTER DR STE 110
ALEXANDRIA VA
22311-1846
US

IV. Provider business mailing address

2901 TELESTAR CT STE 300
FALLS CHURCH VA
22042-1263
US

V. Phone/Fax

Practice location:
  • Phone: 703-751-8111
  • Fax: 703-751-1105
Mailing address:
  • Phone: 703-591-1688
  • Fax: 703-591-1445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE Y. WILLIAMSON
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 703-621-2268