Organization
SENTARA MEDICAL GROUP
Active
Other names
Sentara Pratt Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY A TAYLOR (MANAGER)
(757) 252-2765
Entity
Organization
Contact information
Practice address
95 DUNN DR, STAFFORD, VA 22556-1503
(540) 659-2111
(540) 659-1634
Mailing address
95 DUNN DR, STAFFORD, VA 22556-1503
(540) 659-2111
(540) 659-1634
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
VA
207Q00000X
Family Medicine Physician
Primary
—
VA
2084N0400X
Neurology Physician
—
—
208600000X
Surgery 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
07/10/2015
Last updated
10/18/2016
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