Organization
SENTARA MEDICAL GROUP
Active
Other names
Sentara Pratt Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY A TAYLOR (MANAGER)
(757) 252-2765
Entity
Organization
Contact information
Practice address
7967 KINGS HWY, KING GEORGE, VA 22485-7075
(540) 775-6445
(540) 775-6449
Mailing address
7967 KINGS HWY, KING GEORGE, VA 22485-7075
(540) 775-6445
(540) 775-6449
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
07/17/2015
Last updated
07/17/2015
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