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General NPI Number Information
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NPI Number | 1891088449
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Entity Type | Organization
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Legal Business Name | VIRGINIA SURGICAL CARE CENTER PC
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 16021 KAIROS RD SUITE A
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-5205
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Country | US
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Telephone | 804-931-7720
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Fax | 804-451-1852
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Provider Business Mailing Address
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Address Line | PO BOX 11768
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City | RICHMOND
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State | VA
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Zip | 23230-0168
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Country | US
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Telephone | 804-353-4000
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Fax | 804-213-9783
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Authorized Official
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Title or Position | PRESIDENT
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Name | MURALIDHARAN R BASKER
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Credential | MD
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Telephone | 804-931-7720
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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 | 0101242063
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License Number State | VA
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