Provider Demographics
NPI:1952331829
Name:HEMATOLOGY-ONCOLOGY ASSOCIATES OF FREDERICKSBURG, INC.
Entity Type:Organization
Organization Name:HEMATOLOGY-ONCOLOGY ASSOCIATES OF FREDERICKSBURG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAURER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-371-0079
Mailing Address - Street 1:4501 EMPIRE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-1949
Mailing Address - Country:US
Mailing Address - Phone:540-371-0079
Mailing Address - Fax:540-371-4254
Practice Address - Street 1:4501 EMPIRE CT
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-1949
Practice Address - Country:US
Practice Address - Phone:540-371-0079
Practice Address - Fax:540-371-4254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952331829Medicaid
C06369Medicare PIN