| Nmg Affiliate Practice I, Llc | |
|
15195 Heathcote Blvd Ste 350 Haymarket VA 20169-6242 | |
| (704) 316-7585 | |
| Not Available |
| Full Name | Nmg Affiliate Practice I, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 15195 Heathcote Blvd, Haymarket, Virginia |
| Authorized Official Name and Position | Geoffrey K Gardner (VP OF FINANCE) |
| Authorized Official Contact | 7043167585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nmg Affiliate Practice I, Llc Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 316-7585 | Nmg Affiliate Practice I, Llc 15195 Heathcote Blvd Ste 350 Haymarket VA 20169-6242 Ph: (704) 316-7585 |
| NPI Number | 1265895742 |
|---|---|
| Provider Enumeration Date | 04/01/2016 |
| Last Update Date | 04/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265895742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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