MEDICARE: VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1245010479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP LLC

Provider Business Mailing Address
First Line	:	1715 N GEORGE MASON DR STE 107
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3642
Country	:	US
Telephone Number	:	703-717-4577
Fax Number	:	703-717-4578

Provider Business Practice Location Address
First Line	:	1715 N GEORGE MASON DR STE 107
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3642
Country	:	US
Telephone Number	:	703-717-4577
Fax Number	:	703-717-4578

Authorized Official
Title or Position	:	SYS. AVP MANAGED CARE/CONTRACTING
Name	:	BRENDA BABBITT
Credential	:
Telephone Number	:	703-558-5590

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	01/19/2026

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