| Sentara Medical Group | |
|
12825 Minnieville Rd Ste 202 Lake Ridge VA 22192-3601 | |
| (703) 780-2800 | |
| (844) 700-6186 |
| Full Name | Sentara Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 12825 Minnieville Rd, Lake Ridge, Virginia |
| Authorized Official Name and Position | Cindy A Taylo (MANAGER) |
| Authorized Official Contact | 7572522765 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sentara Medical Group 12825 Minnieville Rd Ste 202 Lake Ridge VA 22192-3601 Ph: (703) 780-2800 | Sentara Medical Group 12825 Minnieville Rd Ste 202 Lake Ridge VA 22192-3601 Ph: (703) 780-2800 |
| NPI Number | 1346601309 |
|---|---|
| Provider Enumeration Date | 03/17/2016 |
| Last Update Date | 08/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346601309 | NPI | - | NPPES |
| C02033 | Other | VA | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Virginia) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (Virginia) | Secondary |
| 207Q00000X | Family Medicine | (Virginia) | Primary |
Amy L Friedenthal Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12512 Lake Ridge Dr Ste D, Lake Ridge, VA 22192 Phone: 703-497-5555 Fax: 703-497-1479 | |
Primary Gerontology Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4196 Merchant Plz Ste 348, Lake Ridge, VA 22192 Phone: 571-206-1650 | |
Potomac Hospital Corporation Of Prince William Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12825 Minnieville Road, Lake Ridge, VA 22192 Phone: 703-523-9800 | |
Patient First Richmond Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2199 Old Bridge Rd, Lake Ridge, VA 22192 Phone: 703-357-9707 Fax: 703-357-9708 |