Provider Demographics
NPI:1922603257
Name:NORTHERN VIRGINIA HEALTHCARE, P.C
Entity Type:Organization
Organization Name:NORTHERN VIRGINIA HEALTHCARE, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-517-8151
Mailing Address - Street 1:3930 PENDER DR STE 270
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-0986
Mailing Address - Country:US
Mailing Address - Phone:703-698-1600
Mailing Address - Fax:703-359-7814
Practice Address - Street 1:3930 PENDER DR STE 270
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-0986
Practice Address - Country:US
Practice Address - Phone:703-698-1600
Practice Address - Fax:703-359-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty