Provider Demographics
NPI:1689734683
Name:PRINCE WILLIAM ORTHOPEDICS HAND SURGERY & SPORTS MEDICINE CENTER
Entity Type:Organization
Organization Name:PRINCE WILLIAM ORTHOPEDICS HAND SURGERY & SPORTS MEDICINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SUBIR
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:JOSSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-393-1667
Mailing Address - Street 1:8525 ROLLING RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-3647
Mailing Address - Country:US
Mailing Address - Phone:703-393-1667
Mailing Address - Fax:703-393-2517
Practice Address - Street 1:8525 ROLLING RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-3647
Practice Address - Country:US
Practice Address - Phone:703-393-1667
Practice Address - Fax:703-393-2517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055429174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG95269Medicare UPIN
6418710001Medicare NSC
VA008321P95Medicare ID - Type Unspecified