Healthcare Provider Details

I. General information

NPI: 1477925642
Provider Name (Legal Business Name): NORTHERN VIRGINIA PELVIC SURGERY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 CAMPUS BLVD SUITE 410
WINCHESTER VA
22601-2872
US

IV. Provider business mailing address

3289 WOODBURN RD SUITE 320
ANNANDALE VA
22003-6800
US

V. Phone/Fax

Practice location:
  • Phone: 571-308-1830
  • Fax: 571-308-1843
Mailing address:
  • Phone: 571-308-1830
  • Fax: 571-308-1843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number1550900
License Number StateVA

VIII. Authorized Official

Name: DR. ANNETTE BICHER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 571-308-1830