Healthcare Provider Details

I. General information

NPI: 1780610808
Provider Name (Legal Business Name): FREDERICKSBURG HOSPITALIST GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SAM PERRY BLVD
FREDERICKSBURG VA
22401-4453
US

IV. Provider business mailing address

1101 SAM PERRY BLVD SUITE 207
FREDERICKSBURG VA
22401-4467
US

V. Phone/Fax

Practice location:
  • Phone: 540-741-3340
  • Fax: 540-741-3348
Mailing address:
  • Phone: 540-741-3340
  • Fax: 540-741-3348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MIRZA BAIG
Title or Position: PARTNER
Credential:
Phone: 540-741-3340