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General NPI Number Information
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NPI Number | 1376672907
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Entity Type | Organization
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Legal Business Name | VIRGINIA CENTER FOR MEDICINE, INC.
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 12/21/2010
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Provider Practice Location Address
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Address Line | 43490 YUKON DRIVE SUITE 210
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City | ASHBURN
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State | VA
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Zip | 20147
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Country | US
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Telephone | 703-726-2566
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Fax | 703-726-1066
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Provider Business Mailing Address
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Address Line | 12797 OWLSLEY WAY
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City | OAK HILL
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State | VA
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Zip | 20171-4223
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHEENA ABRAHAM
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Credential |
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Telephone | 703-726-2566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101056851
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License Number State | VA
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