1386840791 NPI number — NORTHERN VIRGINIA OBGYN ASSOCIATES, LTD.

Table of content: (NPI 1386840791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386840791 NPI number — NORTHERN VIRGINIA OBGYN ASSOCIATES, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHERN VIRGINIA OBGYN ASSOCIATES, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386840791
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8316 ARLINGTON BOULEVARD
Provider Second Line Business Mailing Address:
SUITE 420
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22031-5216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-698-8060
Provider Business Mailing Address Fax Number:
703-876-4691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8316 ARLINGTON BOULEVARD
Provider Second Line Business Practice Location Address:
SUITE 420
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22031-5216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-698-8060
Provider Business Practice Location Address Fax Number:
703-876-4691
Provider Enumeration Date:
06/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BERRY
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
B
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
703-698-8060

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 208600000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 32370009 . This is a "CAREFIRST BCBS DOBRZYNSKI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0101222206 . This is a "LICENSE GLEN H SILAS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0101016735 . This is a "LICENSE DAVID R CARLSON" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 32370003 . This is a "CAREFIRST BCBS MADDOX JOH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32370008 . This is a "CAREFIRST BCBS SILAS GLEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0101037033 . This is a "LICENSE JOHN F MADDOX" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0101046008 . This is a "LICENSE DAVID B BERRY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0101234642 . This is a "LICENSE ANNE M DOBRZYNSKI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 32370001 . This is a "CAREFIRST BCBS CARLSON DR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32370005 . This is a "CAREFIRST BCBS BERRY DAVI" identifier . This identifiers is of the category "OTHER".




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