Provider Demographics
NPI:1891824678
Name:PINNAR SURGICAL ASSOCIATES, LTD
Entity Type:Organization
Organization Name:PINNAR SURGICAL ASSOCIATES, LTD
Other - Org Name:DRS PINNAR, TURGEON & FRAZER, LTD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:PINNAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-709-9701
Mailing Address - Street 1:1850 TOWN CENTER PKWY # 301
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3219
Mailing Address - Country:US
Mailing Address - Phone:703-709-9701
Mailing Address - Fax:703-709-8084
Practice Address - Street 1:1850 TOWN CENTER PKWY # 301
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3219
Practice Address - Country:US
Practice Address - Phone:703-709-9701
Practice Address - Fax:703-709-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101019519208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7347049Medicaid
B93685Medicare UPIN
520108Medicare ID - Type Unspecified