Individual
DR. MARIYA BOURGET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14330 GIDEON DR STE B, WOODBRIDGE, VA 22192-4640
(571) 408-6800
(703) 910-7021
Mailing address
14330 GIDEON DR STE B, WOODBRIDGE, VA 22192-4640
(571) 408-6800
(703) 910-7021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101247265
VA
Other
Enumeration date
04/28/2010
Last updated
05/05/2021
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