| NPI | 1043725336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY BUSH Director Of Clinical Affairs 434-321-5257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101239018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101239018) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: VA 0101239018) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166491) | |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2017-12-08 |