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Organization
MOUNT VERNON ORTHOPAEDICS ASSOC
Active
Organization
MOUNT VERNON ORTHOPAEDICS ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA BIRD (MANAGER)
(703) 765-4321
Entity
Organization
Contact information
Practice address
8101 HINSON FARM RD, SUITE 301, ALEXANDRIA, VA 22306-3403
(703) 765-4321
Mailing address
8101 HINSON FARM RD, SUITE 301, ALEXANDRIA, VA 22306-3403
(703) 765-4321
(703) 780-4558
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
0101035087
VA
207X00000X
Orthopaedic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145530100
DEPARTMENT OF LABOR
—
01
—
176608
METRO MEDICARE GROUP PTAN
—
01
—
4695
CAREFIRST NCA GROUP PROVIDER #
—
Enumeration date
08/01/2006
Last updated
02/19/2010
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