Dominion Medical Center, LLC

Organization Active NPI Internal Medicine Physician · King George, VA

NPI 1114109261 · NPPES record last updated Mar 17, 2008

Key facts

NPI
1114109261
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
DOMINION MEDICAL CENTER, LLC
Practice address
11463 Ridge Rd
King George, VA 22485-4078
Phone
(301) 870-3540
Fax
(301) 392-1726
NPI assigned
Nov 30, 2007
Organization subpart
No

Authorized official

Name
Maryann Ayers
Title
Administrator
Phone
(301) 870-3540

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

35 Colonial Ave
Colonial Beach, VA 22443
Phone (301) 870-3626

11463 Ridge Rd
King George, VA 22485
Phone (540) 775-9200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207R00000X Yes

Addresses

Primary practice location

11463 Ridge Rd
King George, VA 22485-4078

Mailing address

11463 Ridge Rd
P.O. Box 999
King George, VA 22485-4078
Phone (301) 870-3540

Other providers in King George, VA

All providers in King George, VA · Internal Medicine Physician in Virginia

Sources for this page

Verify at the official NPI Registry.