Organization
SENTARA MEDICAL GROUP
Active
Other names
National Breast Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY A TAYLOR (MANAGER)
(757) 252-3344
Entity
Organization
Contact information
Practice address
8988 LORTON STATION BLVD, STE 103, LORTON, VA 22079-4756
(703) 763-4355
(703) 763-4365
Mailing address
8988 LORTON STATION BLVD, STE 103, LORTON, VA 22079-4756
(703) 763-4355
(703) 763-4365
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
02/27/2013
Last updated
02/27/2013
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