Basic Information
| Provider Information | |||||||||
| NPI: | 1811204050 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INOVA PHYSICIAN PARTNERS, INC. - SPECIALISTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | POB 22845 | ||||||||
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| City: | BELFAST | ||||||||
| State: | MD | ||||||||
| PostalCode: | 049154479 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5714235699 | ||||||||
| FaxNumber: | 5714235698 | ||||||||
| Practice Location | |||||||||
| Address1: | 224 CORNWALL ST NW | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201762701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037773262 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2010 | ||||||||
| LastUpdateDate: | 10/25/2018 | ||||||||
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| AuthorizedOfficialLastName: | FLINT | ||||||||
| AuthorizedOfficialFirstName: | LORING | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | CMO (EVP, CMO) | ||||||||
| AuthorizedOfficialTelephone: | 7032085936 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.