Organization
SENTARA MEDICAL GROUP
Active
Other names
Potomac Vascular Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY A TAYLOR (MANAGER)
(757) 252-3344
Entity
Organization
Contact information
Practice address
2296 OPITZ BLVD, STE 260A, WOODBRIDGE, VA 22191-3300
(540) 657-8180
Mailing address
2296 OPITZ BLVD, STE 260A, WOODBRIDGE, VA 22191-3300
(540) 657-8180
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
05/21/2012
Last updated
05/21/2012
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