Provider Demographics
NPI:1063419927
Name:NORTHERN VIRGINIA CARDIOLOGY ASSOCIATES, PC
Entity type:Organization
Organization Name:NORTHERN VIRGINIA CARDIOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DOKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-573-2360
Mailing Address - Street 1:8505 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4621
Mailing Address - Country:US
Mailing Address - Phone:703-573-2360
Mailing Address - Fax:
Practice Address - Street 1:8505 ARLINGTON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4621
Practice Address - Country:US
Practice Address - Phone:703-573-2360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0011524230207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
59049OtherAETNA HMO
002993OtherANTHEM BCBS/TRIGON
6975OtherCAREFIRST BCBS
8562288OtherAETNA PPO
=========OtherNCPPO
=========OtherUNITED HEALTHCARE
=========OtherMAIL HANDLERS
=========OtherMEDICARE - RAILROAD
8562288OtherAETNA PPO
=========OtherMAMSI/ALLIANCE
=========OtherCIGNA PPO
=========OtherKAISER
=========OtherPHCS
=========OtherHEALTHNET/TRICARE/CHAMPUS
=========OtherHEALTHNET/TRICARE/CHAMPUS