Provider Demographics
NPI:1013962836
Name:RADIATION ONCOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:RADIATION ONCOLOGY ASSOCIATES, PC
Other - Org Name:JOHN G. MAYER, MD, PHD, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HETELEKIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-776-3731
Mailing Address - Street 1:9568 KINGS CHARTER DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-0078
Mailing Address - Country:US
Mailing Address - Phone:804-266-8717
Mailing Address - Fax:804-266-5677
Practice Address - Street 1:8081 INNOVATION PARK DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4867
Practice Address - Country:US
Practice Address - Phone:571-472-0606
Practice Address - Fax:571-472-0540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1013962836Medicaid
VA1013962836Medicaid
DC410208Medicare UPIN