Organization
SANDSTON PRIMARY CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHUJA U KHAN MD (OWNER PRESIDENT)
(804) 737-7804
Entity
Organization
Contact information
Practice address
35 E WILLIAMSBURG RD, SANDSTON, VA 23150-2011
(804) 737-7804
(804) 737-8973
Mailing address
35 E WILLIAMSBURG RD, SANDSTON, VA 23150-2011
(804) 737-7804
(804) 737-8973
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
0101053528
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005877814
—
VA
01
—
454249
ANTHEM BCBS
VA
01
—
705067
AETNA
VA
Enumeration date
09/01/2006
Last updated
10/13/2020
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