Provider Demographics
NPI:1518242361
Name:MARY WASHINGTON HEALTHCARE PHYSICIANS
Entity Type:Organization
Organization Name:MARY WASHINGTON HEALTHCARE PHYSICIANS
Other - Org Name:RAPPAHANNOCK NEUROSURGERY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-741-1821
Mailing Address - Street 1:2300 FALL HILL AVE
Mailing Address - Street 2:SUITE 509
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3342
Mailing Address - Country:US
Mailing Address - Phone:540-741-1821
Mailing Address - Fax:
Practice Address - Street 1:1101 SAM PERRY BLVD
Practice Address - Street 2:SUITE 314
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4467
Practice Address - Country:US
Practice Address - Phone:540-374-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty