Organization
SOUTHERN SURGICAL ASSOCIATES LLC
Active
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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