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PHENOM SURGICAL LLC NPI 1871842989


NPI Information

NPI: 1871842989
Provider Name: PHENOM SURGICAL LLC
Classification: Surgery - 208600000X
Entity Type: Organization
Address:
2750 PROSPERITY AVE
#120
FAIRFAX, VA
ZIP 22031
Phone: (703) 659-4557
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PHENOM SURGICAL LLC is a surgery in Fairfax, VA. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. PHENOM SURGICAL LLC NPI is 1871842989. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2750 PROSPERITY AVE
#120
FAIRFAX, VA
ZIP 22031-312
Phone: (703) 659-4557
Fax: (703) 205-9010

The provider's authorized official is Thomas Lamont Hegens .
The authorized official title is Owner/ceo and has the following contact phone number (703) 659-4557.

The enumeration date for this NPI number is 9/5/2012 and was last updated on 5/16/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12906OTHERVIRGINIANATIONAL SURGICAL ASSISTANT ASSOCIATION
2SA0017OTHERDISTRICT OF COLUMBIADEPARTMENT OF HEALTH, HEALTH PROFESSIONAL LICENSING ADMINISTRATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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