# SENTARA MEDICAL GROUP

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

## Provider details

- **NPI number:** 1508240326
- **Authorized official:** CINDY A TAYLOR (MANAGER)
- **Authorized official phone:** (757) 252-2765

## Contact information

- **Practice address:** 12101 CAROL LN, FREDERICKSBURG, VA 22407-6101
- **Practice address phone:** (540) 785-7810
- **Practice address fax:** (540) 786-3099
- **Mailing address:** 12101 CAROL LN, FREDERICKSBURG, VA 22407-6101
- **Mailing address phone:** (540) 785-7810
- **Mailing address fax:** (540) 786-3099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | VA | Yes |
| 208000000X | Pediatrics Physician | — | VA | — |
| 2084P0800X | Psychiatry Physician | — | VA | — |
| 225100000X | Physical Therapist | — | VA | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | VA | — |

## Other

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