Organization
NOVA SPINE CENTER LLC
Active
Other names
Nova Spine Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SHASTI MD (CEO)
(410) 599-9872
Entity
Organization
Contact information
Practice address
21351 GENTRY DR STE 125, STERLING, VA 20166-8511
(410) 599-9872
(703) 683-7801
Mailing address
649 DEERFIELD FARM CT, GREAT FALLS, VA 22066-3934
(410) 599-9872
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
05/05/2023
Last updated
05/05/2025
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