Provider Demographics
NPI:1659692572
Name:NEUROVIRGINIA, PLC
Entity Type:Organization
Organization Name:NEUROVIRGINIA, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:CMPE, HITCM-PP
Authorized Official - Phone:703-248-0111
Mailing Address - Street 1:1635 N GEORGE MASON DR STE 480
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3676
Mailing Address - Country:US
Mailing Address - Phone:703-248-0111
Mailing Address - Fax:703-248-0046
Practice Address - Street 1:1635 N GEORGE MASON DR STE 480
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3676
Practice Address - Country:US
Practice Address - Phone:703-248-0111
Practice Address - Fax:703-248-0046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101247411207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty