Organization
THE RENAISSANCE CENTER FOR PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW G. GOLDBERG M.D. (PRESIDENT)
(703) 264-0904
Entity
Organization
Contact information
Practice address
3700 JOSEPH SIEWICK DR, SUITE 301, FAIRFAX, VA 22033-1744
(703) 264-0904
(703) 264-0906
Mailing address
3700 JOSEPH SIEWICK DR, SUITE 301, FAIRFAX, VA 22033-1744
(703) 264-0904
(703) 264-0906
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12420001
CARE FIRST BLUE CHOICE
VA
01
—
214669
ANTHEM BLUE CROSS BLUE SH
VA
Enumeration date
07/25/2006
Last updated
08/22/2020
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