# SENTARA MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sentara Family & Internal Medicine Physicians
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346601309
- **Authorized official:** CINDY A TAYLO (MANAGER)
- **Authorized official phone:** (757) 252-2765

## Contact information

- **Practice address:** 12825 MINNIEVILLE RD, STE 202, LAKE RIDGE, VA 22192-3601
- **Practice address phone:** (703) 780-2800
- **Practice address fax:** (844) 700-6186
- **Mailing address:** 12825 MINNIEVILLE RD, STE 202, LAKE RIDGE, VA 22192-3601
- **Mailing address phone:** (703) 780-2800
- **Mailing address fax:** (844) 700-6186

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | VA | Yes |
| 207R00000X | Internal Medicine Physician | — | VA | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | VA | — |

## Other

- **Enumeration date:** 03/17/2016
- **Last updated:** 08/25/2016