| Advanced Family Practice | |
|
11453 Abbots Cross Ln Glen Allen VA 23059-1102 | |
| (804) 347-4357 | |
| Not Available |
| Full Name | Advanced Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 11453 Abbots Cross Ln, Glen Allen, Virginia |
| Authorized Official Name and Position | David Anthony Clark (CHAIRMAN) |
| Authorized Official Contact | 8043474357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Family Practice 11453 Abbots Cross Ln Glen Allen VA 23059-1102 Ph: (804) 347-4357 | Advanced Family Practice 11453 Abbots Cross Ln Glen Allen VA 23059-1102 Ph: (804) 347-4357 |
| NPI Number | 1881792661 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 01/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881792661 | NPI | - | NPPES |
| 005647134 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101032223 (Virginia) | Primary |
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