MEDICARE: THE CENTER FOR ORTHOPEDICS, INC.

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	207X00000X	Orthopaedic Surgery Physician	0101028315	VA

General Provider Information

NPI Number	:	1518903038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CENTER FOR ORTHOPEDICS, INC.

Provider Business Mailing Address
First Line	:	2201 CHARLES ST
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-3378
Country	:	US
Telephone Number	:	540-371-5333
Fax Number	:	540-372-6978

Provider Business Practice Location Address
First Line	:	2201 CHARLES ST
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-3378
Country	:	US
Telephone Number	:	540-371-5333
Fax Number	:	540-372-6978

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	ANDRE EGLEVSKY JR.
Credential	:	M.D.
Telephone Number	:	540-371-5333

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	08/05/2008

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