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General NPI Number Information
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NPI Number | 1366498933
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Entity Type | Organization
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Legal Business Name | THE CARDIOVASCULAR GROUP, PC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1900 GALLOWS RD STE 110
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City | VIENNA
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State | VA
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Zip | 22182-4098
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Country | US
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Telephone | 703-281-1265
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Fax | 703-255-0571
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Provider Business Mailing Address
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Address Line | 2901 TELESTAR CT. #300
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1261
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Country | US
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Telephone | 703-591-1688
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Fax | 703-591-1445
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OFFICE
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Name | SUZANNE Y WILLIAMSON
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Credential |
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Telephone | 703-591-1688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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