Provider Demographics
NPI:1962438119
Name:VIRGINIA GYNECOLOGISTS, LTD
Entity type:Organization
Organization Name:VIRGINIA GYNECOLOGISTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECA
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRIMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-281-5007
Mailing Address - Street 1:410 MAPLE AVE W
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4240
Mailing Address - Country:US
Mailing Address - Phone:703-281-5007
Mailing Address - Fax:703-281-3491
Practice Address - Street 1:410 MAPLE AVE W
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4240
Practice Address - Country:US
Practice Address - Phone:703-281-5007
Practice Address - Fax:703-281-3491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty