Bazaco, George C
Bazaco, George C is an individual health care provider with primary practice located at 3650 Joseph Siewick Dr Ste 307, Fairfax VA 22033-1715. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Bazaco, George C can be contacted via phone (703) 391-8804.Contact Information
Primary practice address
3650 Joseph Siewick Dr Ste 307
Fairfax VA 22033-1715
Phone: (703) 391-8804
Fax: (703) 391-5659
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 0101025094 | Virginia |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 0101025094 | Virginia |
Profile Details
| NPI number | 1922000256 |
|---|---|
| LBN Legal business name | Bazaco, George C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2005 |
| Last updated | Nov 26th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922000256 | NPPES |
| Virginia | MEDICAID | 6077803 |
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