| Privia Medical Group, Llc | |
|
8988 Lorton Station Blvd Ste 100 Lorton VA 22079-4757 | |
| (571) 366-8850 | |
| Not Available |
| Full Name | Privia Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8988 Lorton Station Blvd Ste 100, Lorton, Virginia |
| Authorized Official Name and Position | Courtney Ainsworth Ivess (ASSOCIATE DIRECTOR, CREDENTIALING) |
| Authorized Official Contact | 5713668831 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Privia Medical Group, Llc 950 N Glebe Rd Ste 700 Arlington VA 22203-4173 Ph: (571) 366-8850 | Privia Medical Group, Llc 8988 Lorton Station Blvd Ste 100 Lorton VA 22079-4757 Ph: (571) 366-8850 |
| NPI Number | 1962053306 |
|---|---|
| Provider Enumeration Date | 09/26/2019 |
| Last Update Date | 03/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962053306 | NPI | - | NPPES |
| 7442750009 | Other | DME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 213E00000X | Podiatrist | (* (Not Available)) | Secondary |
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