Organization
CCRM VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK PAYSON M.D. (PRACTICE DIRECTOR)
57178921005
Entity
Organization
Contact information
Practice address
8010 TOWERS CRESCENT DR, VIENNA, VA 22182-2710
(571) 789-2100
Mailing address
8010 TOWERS CRESCENT DR, VIENNA, VA 22182-2710
(571) 789-2100
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
0101243183
VA
Other
Enumeration date
03/27/2017
Last updated
03/27/2017
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