Organization
PREMIER TRAUMA AND SURGICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD PUCCIO MD (PRESIDENT)
(703) 858-6044
Entity
Organization
Contact information
Practice address
44045 RIVERSIDE PKWY, LEESBURG, VA 20176-5101
(703) 858-6040
Mailing address
PO BOX 79295, BALTIMORE, MD 21279-9295
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
—
—
Other
Enumeration date
01/06/2017
Last updated
04/19/2017
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