Healthcare Provider Details

I. General information

NPI: 1801953203
Provider Name (Legal Business Name): NORTHERN VIRGINIA SURGICAL SPECIALISTS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 05/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 HOSPITAL DR
WARRENTON VA
20186-3026
US

IV. Provider business mailing address

432 HOSPITAL DR
WARRENTON VA
20186-3026
US

V. Phone/Fax

Practice location:
  • Phone: 540-347-2805
  • Fax: 540-347-5399
Mailing address:
  • Phone: 540-347-2805
  • Fax: 540-347-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH G FARR
Title or Position: PRESIDENT
Credential: MD
Phone: 540-347-2805