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
2300 OPITZ BLVD, HEART AND VASCULAR CENTER, WOODBRIDGE, VA 22191-3345
(703) 680-4254
(855) 210-2385
Mailing address
2300 OPITZ BLVD, HEART AND VASCULAR CENTER, WOODBRIDGE, VA 22191-3345
(703) 680-4254
(855) 210-2385
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
01/07/2013
Last updated
01/07/2013
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