Healthcare Provider Details

I. General information

NPI: 1356435580
Provider Name (Legal Business Name): VIRGINIA SPINE INSTITUTE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 SUNRISE VALLEY DR STE 800
RESTON VA
20191
US

IV. Provider business mailing address

11800 SUNRISE VALLEY DR STE 600
RESTON VA
20191-5327
US

V. Phone/Fax

Practice location:
  • Phone: 703-709-1114
  • Fax: 703-709-1117
Mailing address:
  • Phone: 703-709-1114
  • Fax: 703-709-6516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS CONRAD SCHULER
Title or Position: PRESIDENT
Credential: MD
Phone: 703-709-1114