| Orthovirginia, Inc. | |
|
1760 Old Meadow Rd Ste 500 Mc Lean VA 22102-4306 | |
| (703) 810-5217 | |
| (703) 810-5475 |
| Full Name | Orthovirginia, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1760 Old Meadow Rd Ste 500, Mc Lean, Virginia |
| Authorized Official Name and Position | Nicole Proffitt (CREDENTIALING & ENROLLMENT) |
| Authorized Official Contact | 8045332357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orthovirginia, Inc. Po Box 715868 Philadelphia PA 19171-5868 Ph: (804) 915-1910 | Orthovirginia, Inc. 1760 Old Meadow Rd Ste 500 Mc Lean VA 22102-4306 Ph: (703) 810-5217 |
| NPI Number | 1154946093 |
|---|---|
| Provider Enumeration Date | 06/16/2020 |
| Last Update Date | 06/03/2022 |
| Certification Date | 06/03/2022 |
| Medicare PECOS PAC ID | 0547157224 |
|---|---|
| Medicare Enrollment ID | O20200805002152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154946093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
| 207X00000X | Orthopaedic Surgery | (NU) | Secondary |
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