Organization
SOUTHERN SURGICAL ASSOCIATES LLC
Active
Other names
Commonwealth Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VASKEN KEVORK TENEKJIAN M.D. (PRESIDENT)
(757) 397-2383
Entity
Organization
Contact information
Practice address
3640 HIGH ST, SUITE 2F, PORTSMOUTH, VA 23707-3213
(757) 397-2383
(757) 397-5201
Mailing address
3640 HIGH ST, SUITE 2F, PORTSMOUTH, VA 23707-3213
(757) 397-2383
(757) 397-5201
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05853
MEDICARE GROUP NUMBER
VA
Enumeration date
07/04/2006
Last updated
01/14/2008
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