Organization
SURGICAL SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRESCOTT WADE PRILLAMAN MD (PRESIDENT)
(804) 683-5849
Entity
Organization
Contact information
Practice address
12439 WALNUT HILL DRIVE, ROCKVILLE, VA 23146
(804) 749-4249
Mailing address
P.O BOX 99, ROCKVILLE, VA 23146
(804) 749-4249
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086X0206X
Surgical Oncology Physician
—
—
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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