Provider Demographics
NPI:1467060236
Name:VIRGINIA SPORTS MEDICINE DOCTORS
Entity Type:Organization
Organization Name:VIRGINIA SPORTS MEDICINE DOCTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:703-646-1270
Mailing Address - Street 1:3998 FAIR RIDGE DR STE 125
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2908
Mailing Address - Country:US
Mailing Address - Phone:703-646-1270
Mailing Address - Fax:
Practice Address - Street 1:3998 FAIR RIDGE DR STE 125
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2908
Practice Address - Country:US
Practice Address - Phone:703-646-1270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty