Healthcare Provider Details

I. General information

NPI: 1821016783
Provider Name (Legal Business Name): VIRGINIA CANCER CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19415 DEERFIELD AVE STE 107
LANSDOWNE VA
20176-8470
US

IV. Provider business mailing address

19415 DEERFIELD AVE STE 107
LANSDOWNE VA
20176-8470
US

V. Phone/Fax

Practice location:
  • Phone: 703-729-6030
  • Fax: 703-729-1446
Mailing address:
  • Phone: 703-729-6030
  • Fax: 703-729-1446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAVNEET GREWAL
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 703-729-6030