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General NPI Number Information
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NPI Number | 1841349107
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Entity Type | Organization
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Legal Business Name | SURGICAL SPECIALISTS OF NORTHERN VIRGINIA
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8988 LORTON STATION BLVD SUITE 202
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City | LORTON
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State | VA
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Zip | 22079-4733
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Country | US
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Telephone | 703-313-8808
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Fax | 703-313-8850
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Provider Business Mailing Address
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Address Line | 114 QUAY ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2609
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Country | US
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Telephone | 703-313-8808
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Fax | 703-313-8850
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID CHARLES WEINTRITT
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Credential | M.D.
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Telephone | 703-313-8808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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