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General NPI Number Information
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NPI Number | 1689095523
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Entity Type | Organization
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Legal Business Name | NE VIRGINIA EMERGENCY PHYSICIANS LLC
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 3300 GALLOWS RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3307
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Country | US
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Telephone | 703-776-3116
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Fax |
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Provider Business Mailing Address
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Address Line | 100 WITMER RD STE 220
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City | HORSHAM
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State | PA
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Zip | 19044-2279
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Country | US
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Telephone | 954-838-2371
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | KAREN VAUGHN
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Credential |
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Telephone | 404-450-4684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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