Organization
SENTARA MEDICAL GROUP
Active
Other names
Sentara Family & Internal Medicine Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY A TAYLO (MANAGER)
(757) 252-2765
Entity
Organization
Contact information
Practice address
12825 MINNIEVILLE RD, STE 202, LAKE RIDGE, VA 22192-3601
(703) 780-2800
(844) 700-6186
Mailing address
12825 MINNIEVILLE RD, STE 202, LAKE RIDGE, VA 22192-3601
(703) 780-2800
(844) 700-6186
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
VA
207R00000X
Internal Medicine Physician
—
VA
332B00000X
Durable Medical Equipment & Medical Supplies
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
03/17/2016
Last updated
08/25/2016
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