Provider Demographics
NPI:1447311378
Name:CARDIOLOGY SPECIALISTS OF VIRGINIA
Entity type:Organization
Organization Name:CARDIOLOGY SPECIALISTS OF VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:O BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-823-6904
Mailing Address - Street 1:6715 LITTLE RIVER TPKE STE 300
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3546
Mailing Address - Country:US
Mailing Address - Phone:703-751-6668
Mailing Address - Fax:703-642-1049
Practice Address - Street 1:6715 LITTLE RIVER TPKE STE 300
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3546
Practice Address - Country:US
Practice Address - Phone:703-751-6668
Practice Address - Fax:703-642-1049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
J423OtherCAREFIRST
VADA7234OtherRAILROAD MEDICARE
VAG01424Medicare ID - Type UnspecifiedDC METRO AREA