Organization
MAURICIO D. BAS, JR., M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICIO D BAS JR. M.D. (PRESIDENT)
(703) 494-8174
Entity
Organization
Contact information
Practice address
1970 OPITZ BLVD, WOODBRIDGE, VA 22191-3304
(703) 494-8174
Mailing address
PO BOX 4806, WOODBRIDGE, VA 22194-4806
(703) 580-5580
(703) 580-5570
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
0101022428
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
249067
ANTHEM BLUE CROSS
VA
05
—
7449569
—
VA
Enumeration date
04/02/2007
Last updated
08/22/2020
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