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General NPI Number Information
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NPI Number | 1659793891
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Entity Type | Organization
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Legal Business Name | INOVA AMBULATORY SURGERY CENTER AT LORTON, LLC
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 9321 SANGER ST SUITE 200
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City | LORTON
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State | VA
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Zip | 22079-2720
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Country | US
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Telephone | 703-922-7631
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Fax |
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Provider Business Mailing Address
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Address Line | 9321 SANGER ST SUITE 200
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City | LORTON
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State | VA
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Zip | 22079-2720
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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 | VICE-PRESIDENT AMBULATORY SURGERY
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Name | MR. ARTUR SIVASLIAN
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Credential |
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Telephone | 703-922-5345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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