Organization
NORTHERN VIRGINIA PEDIATRIC ORTHOPAEDICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE DAMON GANTSOUDES MD (CHIEF MEDICAL DIRECTOR)
(571) 306-1525
Entity
Organization
Contact information
Practice address
8316 ARLINGTON BLVD STE 500, FAIRFAX, VA 22031-5216
(646) 240-9444
Mailing address
1110 WESTBRIAR CT NE, VIENNA, VA 22180-3665
(646) 240-9444
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
09/19/2025
Last updated
09/22/2025
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