Provider Demographics
NPI: | 1639511504 |
---|---|
Name: | VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP, LLC |
Entity type: | Organization |
Organization Name: | VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ZABROWSKI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 703-558-5000 |
Mailing Address - Street 1: | 1851 N GEORGE MASON DR STE 4A |
Mailing Address - Street 2: | |
Mailing Address - City: | ARLINGTON |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22207-1953 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 703-717-4200 |
Mailing Address - Fax: | 703-717-4201 |
Practice Address - Street 1: | 1851 N GEORGE MASON DR STE 4A |
Practice Address - Street 2: | |
Practice Address - City: | ARLINGTON |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22207-1953 |
Practice Address - Country: | US |
Practice Address - Phone: | 703-717-4200 |
Practice Address - Fax: | 703-717-4201 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-07-22 |
Last Update Date: | 2025-02-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Single Specialty |