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General NPI Number Information
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NPI Number | 1982757043
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC & SPORTS MEDICINE ASSOC PC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 133 MAPLE AVE E SUITE 300
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City | VIENNA
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State | VA
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Zip | 22180
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Country | US
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Telephone | 703-281-2457
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Fax | 703-281-1055
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Provider Business Mailing Address
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Address Line | 133 MAPLE AVE E SUITE 300
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City | VIENNA
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State | VA
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Zip | 22180
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Country | US
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Telephone | 703-281-2457
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Fax | 703-281-1055
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. MELINDA GAY GAERTNER
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Credential |
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Telephone | 703-281-2457
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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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