Healthcare Provider Details

I. General information

NPI: 1083056964
Provider Name (Legal Business Name): VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GEORGE MASON DR WOUND CARE SUITE G200
ARLINGTON VA
22205-3610
US

IV. Provider business mailing address

1701 N GEORGE MASON DR WOUND CARE SUITE G200
ARLINGTON VA
22205-3610
US

V. Phone/Fax

Practice location:
  • Phone: 703-558-6600
  • Fax: 703-558-6625
Mailing address:
  • Phone: 703-558-6600
  • Fax: 703-558-6625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: BRENDA BABBITT
Title or Position: SYS. AVP MANAGED CARE/CONTRACTING
Credential:
Phone: 703-558-5590