Healthcare Provider Details

I. General information

NPI: 1164872370
Provider Name (Legal Business Name): JASMINE K VIRK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2016
Last Update Date: 09/02/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10600 SPOTSYLVANIA AVE
FREDERICKSBURG VA
22408-2637
US

IV. Provider business mailing address

1340 CENTRAL PARK BLVD STE 100
FREDERICKSBURG VA
22401-4940
US

V. Phone/Fax

Practice location:
  • Phone: 540-604-9500
  • Fax:
Mailing address:
  • Phone: 540-741-4282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD479132
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101265894
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: