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General NPI Number Information
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NPI Number | 1457458598
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Entity Type | Organization
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Legal Business Name | NORTHERN VIRGINIA RADIATION ONCOLOGY PC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 4320 SEMINARY RD RADIATION ONCOLOGY DEPT.
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1535
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Country | US
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Telephone | 703-504-7900
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Fax | 703-504-7979
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Provider Business Mailing Address
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Address Line | 4320 SEMINARY RD RADIATION ONCOLOGY DEPT.
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1535
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Country | US
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Telephone | 703-504-7900
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | JANE GRAYSON
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Credential | M.D.
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Telephone | 703-504-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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