Provider Demographics
NPI:1922482066
Name:METROPOLITAN SURGICAL SPECIALISTS
Entity Type:Organization
Organization Name:METROPOLITAN SURGICAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-544-8971
Mailing Address - Street 1:2755 HARTLAND ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043
Mailing Address - Country:US
Mailing Address - Phone:703-544-8971
Mailing Address - Fax:703-562-6994
Practice Address - Street 1:2755 HARTLAND RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-3540
Practice Address - Country:US
Practice Address - Phone:703-544-8971
Practice Address - Fax:703-562-6994
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREATER WASHINGTON PLASTIC SURGERY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-18
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258156208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty