Healthcare Provider Details

I. General information

NPI: 1487748240
Provider Name (Legal Business Name): CARDIOLOGY ASSOCIATES OF FREDERICKSBURG, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9530 COSNER DR SUITE 200
FREDERICKSBURG VA
22408-7760
US

IV. Provider business mailing address

9530 COSNER DR SUITE 200
FREDERICKSBURG VA
22408-7760
US

V. Phone/Fax

Practice location:
  • Phone: 540-373-1331
  • Fax: 540-373-1124
Mailing address:
  • Phone: 540-373-1331
  • Fax: 540-373-1124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateVA

VIII. Authorized Official

Name: FRANK R SNOW
Title or Position: PRESIDENT
Credential: M.D.
Phone: 540-373-1331