Healthcare Provider Details
I. General information
NPI: 1396504247
Provider Name (Legal Business Name): VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2024
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1635 N GEORGE MASON DR STE 430
ARLINGTON VA
22205-3617
US
IV. Provider business mailing address
1635 N GEORGE MASON DR STE 430
ARLINGTON VA
22205-3617
US
V. Phone/Fax
- Phone: 703-842-4188
- Fax: 703-647-1074
- Phone: 703-842-4188
- Fax: 703-647-1074
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
ZABROWSKI
Title or Position: CFO
Credential:
Phone: 703-558-5000