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5875 Bremo Rd Suite 110 Richmond VA 23226-1934 | |
(804) 288-1040 | |
(804) 288-2632 |
Full Name | |
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Speciality | Family Medicine |
Location | 5875 Bremo Rd, Richmond, Virginia |
Authorized Official Name and Position | George O Butler (DIR., CORP., RESPONSIBILITY) |
Authorized Official Contact | 8042810271 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5875 Bremo Rd Suite 110 Richmond VA 23226-1934 Ph: (804) 288-1040 | 5875 Bremo Rd Suite 110 Richmond VA 23226-1934 Ph: (804) 288-1040 |
NPI Number | 1205116886 |
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Provider Enumeration Date | 08/26/2011 |
Last Update Date | 10/24/2018 |
Identifier | Type | State | Issuer |
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1205116886 | NPI | - | NPPES |
C06778 | Other | VA | GROUP PTAN |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mary Brantley Holmes Msn Whnp-bc Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8955 Wishart Rd, Richmond, VA 23229 Phone: 804-928-5596 | |
Independent Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7605 Forest Ave, Ste 211, Richmond, VA 23229 Phone: 804-282-3114 Fax: 804-285-9723 | |