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General NPI Number Information
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NPI Number | 1689528820
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Entity Type | Organization
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Legal Business Name | PRIVIA MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 3925 BLENHEIM BLVD STE 52
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City | FAIRFAX
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State | VA
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Zip | 22030-2426
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Country | US
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Telephone | 703-642-7522
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Fax |
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Provider Business Mailing Address
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Address Line | 2810 OLD LEE HWY STE 305
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City | FAIRFAX
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State | VA
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Zip | 22031-4376
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Country | US
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Telephone | 703-642-7522
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Fax |
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Authorized Official
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Title or Position | ENROLLMENT SPECIALIST
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Name | REBECCA INOA
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Credential |
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Telephone | 800-973-1442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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