| NPI | 1215967203 |
|---|---|
| Doing Business As | AVERA MEDICAL GROUP FAIRFAX |
| Entity Type | Organization |
| Authorized Contact | JULIE N NORTON Vice President Of Finance 605-322-6375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2011-03-21 |