CHARLES WAYNE MCDONOUGH

RICHMOND, VA
NPI1619540705
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: VA  0024182163)
Enumeration Date2021-07-19
Last Update Date2021-07-19
Business Address
CHARLES WAYNE MCDONOUGH
6714 PATTERSON AVE STE 204
RICHMOND, VA 23226-3432
Phone number: 804-282-3387
Mailing Address
CHARLES WAYNE MCDONOUGH
9212 SHADY GROVE RD
MECHANICSVILLE, VA 23116-2845
Phone number: 804-873-9379