Organization
SENTARA MEDICAL GROUP
Active
Other names
Sentara Surgery Specialists, SENTARA NEUROLOGY SPECIALISTS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORIS PRINCE (MANAGER)
(757) 252-2760
Entity
Organization
Contact information
Practice address
2280 OPITZ BLVD, STE 110, WOODBRIDGE, VA 22191-3362
(035) 238-8807
(757) 648-1954
Mailing address
2280 OPITZ BLVD, STE 110, WOODBRIDGE, VA 22191-3362
(703) 523-8880
(855) 462-1102
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
03/25/2014
Last updated
01/10/2020
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