Organization
THE MEDICAL CENTER OF STAFFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK B BUSTIN M.D. (ADMINISTRATOR)
(504) 659-4157
Entity
Organization
Contact information
Practice address
608 GARRISONVILLE RD, SUITE 201, STAFFORD, VA 22554-3706
(540) 659-4157
(540) 659-3482
Mailing address
608 GARRISONVILLE RD, SUITE 201, STAFFORD, VA 22554-3706
(540) 659-4157
(540) 659-3482
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026692
BLUE CROSS/BLUE SHIELD
VA
01
—
250600
MAMSI/ALLIANCE
VA
Enumeration date
08/31/2006
Last updated
10/22/2007
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