Organization
NORTHERN VIRGINIA PATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ANTHONY WERNESS M.D. (PRESIDENT)
(703) 391-3654
Entity
Organization
Contact information
Practice address
3600 JOSEPH SIEWICK DR, FAIRFAX, VA 22033-1709
(703) 391-3654
(703) 391-3049
Mailing address
PO BOX 100559, FLORENCE, SC 29501-0559
(843) 646-4300
(843) 646-4308
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
MD0101042785
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101049095
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
187030
BCBS
VA
Enumeration date
04/14/2006
Last updated
01/15/2008
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