Provider Demographics
NPI:1770654113
Name:VIRGINIA HEAD AND NECK SURGEONS PC
Entity type:Organization
Organization Name:VIRGINIA HEAD AND NECK SURGEONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-858-4439
Mailing Address - Street 1:19455 DEERFIELD AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8102
Mailing Address - Country:US
Mailing Address - Phone:703-858-4439
Mailing Address - Fax:703-858-4489
Practice Address - Street 1:19455 DEERFIELD AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8102
Practice Address - Country:US
Practice Address - Phone:703-858-4439
Practice Address - Fax:703-858-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207Y00000X, 207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric OtolaryngologyGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADF9763OtherMEDICARE RR
VADF9763OtherMEDICARE RR
VAA304Medicare PIN
DC140868Medicare PIN