# NORTHERN VIRGINIA MULTI-SPECIALTY, LLC

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

## Provider details

- **NPI number:** 1366114167
- **Authorized official:** WILLIAM TEDERICK JOHNSON (GROUP VP/AO)
- **Authorized official phone:** (615) 372-3375

## Contact information

- **Practice address:** 1860 TOWN CENTER DR STE 350, RESTON, VA 20190-5912
- **Practice address phone:** (703) 224-9999
- **Practice address fax:** (571) 384-6702
- **Mailing address:** 2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
- **Mailing address phone:** (615) 376-7600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/30/2021
- **Last updated:** 09/30/2021