# PRIVIA MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245169853
- **Authorized official:** BRIANNA FOULKROD (AVP, CRED & ENROLLMENT)
- **Authorized official phone:** (571) 650-2710

## Contact information

- **Practice address:** 3460 OLD WASHINGTON RD STE 203A, WALDORF, MD 20602-3243
- **Practice address phone:** (301) 638-9670
- **Mailing address:** 950 N GLEBE RD STE 700, ARLINGTON, VA 22203-4173
- **Mailing address phone:** (800) 973-1442

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/18/2026
- **Last updated:** 05/18/2026