Provider Demographics
NPI:1710132675
Name:VIRGINIA MEDICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:VIRGINIA MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-402-0765
Mailing Address - Street 1:6128 BRANDON AVE STE 221
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2640
Mailing Address - Country:US
Mailing Address - Phone:703-942-5460
Mailing Address - Fax:703-942-5630
Practice Address - Street 1:6128 BRANDON AVE STE 221
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2640
Practice Address - Country:US
Practice Address - Phone:703-942-5460
Practice Address - Fax:703-942-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5686657OtherAETNA
VA466590OtherANTHEM
VA193676203OtherUNITED HEALTHCARE
VAB300008OtherCAREFIRST BCBS
VA8132487OtherMAMSI
VA466590OtherANTHEM
VA008437134Medicare PIN