| Nmg Affiliate Practice I, Llc | |
|
6208 Multiplex Dr Suite 150 Centreville VA 20121-5324 | |
| (703) 366-2590 | |
| (703) 366-2591 |
| Full Name | Nmg Affiliate Practice I, Llc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 6208 Multiplex Dr, Centreville, Virginia |
| Authorized Official Name and Position | Geoffrey K Gardner (VP OF FINANCE) |
| Authorized Official Contact | 7033662590 |
| 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) 384-7840 | Nmg Affiliate Practice I, Llc 6208 Multiplex Dr Suite 150 Centreville VA 20121-5324 Ph: (703) 366-2590 |
| NPI Number | 1881046993 |
|---|---|
| Provider Enumeration Date | 07/13/2016 |
| Last Update Date | 07/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881046993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207P00000X | Emergency Medicine | (* (Not Available)) | Primary |
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