Provider Demographics
NPI:1194937912
Name:VIRGINIA PAIN SPECIALISTS, INC.
Entity type:Organization
Organization Name:VIRGINIA PAIN SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NINO
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOBROVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-336-9828
Mailing Address - Street 1:46400 BENEDICT DR
Mailing Address - Street 2:SUITE 001
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-6604
Mailing Address - Country:US
Mailing Address - Phone:540-336-9828
Mailing Address - Fax:
Practice Address - Street 1:46400 BENEDICT DR
Practice Address - Street 2:SUITE 001
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-6604
Practice Address - Country:US
Practice Address - Phone:540-336-9828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051921208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI12436Medicare UPIN