Provider Demographics
NPI:1821016783
Name:VIRGINIA CANCER CARE, INC.
Entity Type:Organization
Organization Name:VIRGINIA CANCER CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-729-6030
Mailing Address - Street 1:19415 DEERFIELD AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8470
Mailing Address - Country:US
Mailing Address - Phone:703-729-6030
Mailing Address - Fax:703-729-1446
Practice Address - Street 1:19415 DEERFIELD AVE STE 107
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8470
Practice Address - Country:US
Practice Address - Phone:703-729-6030
Practice Address - Fax:703-729-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010057141Medicaid
VA010057141Medicaid
VAI03244Medicare UPIN
VAC09228Medicare PIN