Healthcare Provider Details

I. General information

NPI: 1346294519
Provider Name (Legal Business Name): VIRGINIA CANCER SPECIALISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8613 LEE HWY # 200N
FAIRFAX VA
22031-2171
US

IV. Provider business mailing address

3040 WILLIAMS DR SUITE 100
FAIRFAX VA
22031-4618
US

V. Phone/Fax

Practice location:
  • Phone: 703-280-5390
  • Fax: 703-280-9596
Mailing address:
  • Phone: 703-280-5390
  • Fax: 703-205-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: ELISE POWERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 703-208-3991