Unknown Individual – Specialist, NPI 1629046180
Specialist
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
3580 Joseph Siewick Dr Ste 206
Fairfax, VA 220331764
Phone: (571) 472-4100
Fax: (571) 472-4101
Type: Location
3300 Gallows Rd
Falls Church, VA 220423307
Phone: (703) 776-4001
Fax: (703) 776-7113
Type: Location
1500 N Beauregard St Ste 300
Alexandria, VA 223111715
Phone: (571) 472-4100
Fax: (571) 472-4101
Type: Location
1916, Opitz Boulevard, Featherstone, Woodbridge, Prince William County, Virginia, 22191, United States
WOODBRIDGE, VA 221913304
Phone: (703) 551-4113
Fax: (703) 491-1019
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 22033)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NEUROSURGERY | VA | 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 73 | 23 |
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