Organization
INOVA OAKVILLE AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARASINH PHOUMMITHONE MAYARD (A/R & OPERATIONS MANAGER)
(703) 395-6410
Entity
Organization
Contact information
Practice address
400 FANNON ST STE 200, ALEXANDRIA, VA 22301
(703) 672-2635
(703) 672-2650
Mailing address
400 FANNON ST., 200, ALEXANDRIA, VA 22301
(703) 672-2624
(703) 672-2650
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/02/2024
Last updated
09/10/2024
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