| NPI | 1154374296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA CUNNINGHAM CEO/Practice Administrator 804-249-8302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: VA 0102050193) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-08-06 |