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Organization

DERMATOLOGY ASSOCIATES OF FREDERICKSBURG

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HENRY G SACKS MD (OWNER PRESIDENT)
(540) 373-1080
Entity
Organization

Contact information

Practice address
2301 FALL HILL AVE, SUITE106, FREDERICKSBURG, VA 22401-3349
(540) 373-1080
(540) 373-1094
Mailing address
2301 FALL HILL AVE, SUITE106, FREDERICKSBURG, VA 22401-3349
(540) 373-1080
(540) 373-1094

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101027880
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005900425
VA
01
100699
ANTHEM BLUECROSS
VA
Enumeration date
03/23/2007
Last updated
04/25/2023
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