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General NPI Number Information
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NPI Number | 1932658929
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Entity Type | Organization
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Legal Business Name | VIRGINIA NEURO CARE
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Dates
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Enumeration Date | 10/02/2016
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Last Update Date | 10/02/2016
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Provider Practice Location Address
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Address Line | 7616 SEABROOK LN
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City | SPRINGFIELD
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State | VA
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Zip | 22153-2163
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Country | US
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Telephone | 703-879-2756
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Fax |
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Provider Business Mailing Address
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Address Line | 7616 SEABROOK LN
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City | SPRINGFIELD
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State | VA
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Zip | 22153-2163
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Country | US
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Telephone | 703-879-2756
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Fax |
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Authorized Official
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Title or Position | NEUROLOGIST
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Name | SADIA KHAN
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Credential | MD
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Telephone | 703-879-2756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 0101239509
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License Number State | VA
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