Organization
NORTHERN VIRGINIA SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARASINH PHOUMMITHONE MAYARD (AR & OPERATIONS MANAGER)
(703) 395-6410
Entity
Organization
Contact information
Practice address
3620 JOSEPH SIEWICK DR STE 202, FAIRFAX, VA 22033-1758
(703) 766-6960
(703) 766-6980
Mailing address
3620JOSEPH SIEWICK DRIVE, SUITE 202, FAIRFAX, VA 22033
(703) 766-6960
(703) 766-6980
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/09/2008
Last updated
03/13/2024
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