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Organization

NORTHERN VIRGINIA MULTI-SPECIALTY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM TEDERICK JOHNSON (GROUP VP/AO)
(615) 372-3375
Entity
Organization

Contact information

Practice address
1860 TOWN CENTER DR STE 350, RESTON, VA 20190-5912
(703) 224-9999
(571) 384-6702
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 376-7600

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Enumeration date
09/30/2021
Last updated
09/30/2021
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