Provider Demographics
NPI:1225624679
Name:VIRGINIA PULMONOLOGY AND CRITICAL CARE LLC
Entity Type:Organization
Organization Name:VIRGINIA PULMONOLOGY AND CRITICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:DOLOJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-213-2272
Mailing Address - Street 1:4604 SPOTSYLVANIA PKWY STE 340
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBRG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7767
Mailing Address - Country:US
Mailing Address - Phone:276-783-1827
Mailing Address - Fax:276-783-2879
Practice Address - Street 1:4604 SPOTSYLVANIA PKWY STE 340
Practice Address - Street 2:
Practice Address - City:FREDERICKSBRG
Practice Address - State:VA
Practice Address - Zip Code:22408-7767
Practice Address - Country:US
Practice Address - Phone:276-783-1827
Practice Address - Fax:276-783-2879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30017614450001Medicaid