| Mosaic Care Center | |
|
10514 Wakeman Dr Fredericksburg VA 22407-8040 | |
| (540) 907-4555 | |
| (833) 918-2314 |
| Full Name | Mosaic Care Center |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 10514 Wakeman Dr, Fredericksburg, Virginia |
| Authorized Official Name and Position | Joseph Lyttle (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5409074555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Care Center 4343 Plank Rd Ste 100 Fredericksburg VA 22407-4807 Ph: (540) 907-4555 | Mosaic Care Center 10514 Wakeman Dr Fredericksburg VA 22407-8040 Ph: (540) 907-4555 |
| NPI Number | 1104170398 |
|---|---|
| Provider Enumeration Date | 11/09/2012 |
| Last Update Date | 08/30/2022 |
| Certification Date | 08/30/2022 |
| Medicare PECOS PAC ID | 8628495116 |
|---|---|
| Medicare Enrollment ID | O20200828001684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104170398 | NPI | - | NPPES |
| Provider Name | Crystal D Miller Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750634770 PECOS PAC ID: 9830327733 Enrollment ID: I20140123001134 |
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