Privia Medical Group, LLC

NPI #1962053306 in Lorton, Virginia

Provider Information

NPI Number: 1962053306
Entity Type: Organization
Organization Name: Privia Medical Group, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Sep 26, 2019
Last Updated: Mar 5, 2020

Practice Location

Address: 8988 LORTON STATION BLVD STE 100
City: Lorton
State: Virginia
ZIP Code: 22079-4757
Phone: (571) 366-8850

Authorized Official

Name: COURTNEY AINSWORTH IVESS
Title: ASSOCIATE DIRECTOR, CREDENTIALING
Phone: (571) 366-8831

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X
Internal Medicine	207R00000X	Primary

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