| Privia Medical Group, Llc | |
|
24560 Southpoint Dr Ste 200 Aldie VA 20105-3505 | |
| (315) 601-0174 | |
| Not Available |
| Full Name | Privia Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 24560 Southpoint Dr Ste 200, Aldie, Virginia |
| Authorized Official Name and Position | Courtney Ainsworth Ivess (ASSOCIATE DIRECTOR, CREDENTIALING) |
| Authorized Official Contact | 5713668831 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Privia Medical Group, Llc 950 N Glebe Rd Ste 700 Arlington VA 22203-4173 Ph: (571) 366-8850 | Privia Medical Group, Llc 24560 Southpoint Dr Ste 200 Aldie VA 20105-3505 Ph: (315) 601-0174 |
| NPI Number | 1154961316 |
|---|---|
| Provider Enumeration Date | 01/15/2020 |
| Last Update Date | 03/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154961316 | NPI | - | NPPES |
| 7442750011 | Other | VA | MEDICARE DME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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