# SENTARA MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sentara Pratt Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477937209
- **Authorized official:** MRS. CINDY A TAYLOR (MANAGER)
- **Authorized official phone:** (757) 252-2765

## Contact information

- **Practice address:** 95 DUNN DR, STAFFORD, VA 22556-1503
- **Practice address phone:** (540) 659-2111
- **Practice address fax:** (540) 659-1634
- **Mailing address:** 95 DUNN DR, STAFFORD, VA 22556-1503
- **Mailing address phone:** (540) 659-2111
- **Mailing address fax:** (540) 659-1634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | VA | — |
| 207Q00000X | Family Medicine Physician | — | VA | Yes |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 208600000X | Surgery Physician | — | VA | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | VA | — |

## Other

- **Enumeration date:** 07/10/2015
- **Last updated:** 10/18/2016