| Bon Secours Freedom Healthcare Associates | |
|
32 W Washington St Suite B Petersburg VA 23803-4224 | |
| (804) 431-3400 | |
| (804) 733-3858 |
| Full Name | Bon Secours Freedom Healthcare Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 32 W Washington St, Petersburg, Virginia |
| Authorized Official Name and Position | George O Butler (DIRECTOR CORPORATE RESPONSIBILITY) |
| Authorized Official Contact | 8042810271 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bon Secours Freedom Healthcare Associates 32 W Washington St Suite B Petersburg VA 23803-4224 Ph: (804) 431-3400 | Bon Secours Freedom Healthcare Associates 32 W Washington St Suite B Petersburg VA 23803-4224 Ph: (804) 431-3400 |
| NPI Number | 1124421318 |
|---|---|
| Provider Enumeration Date | 10/01/2014 |
| Last Update Date | 10/01/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124421318 | NPI | - | NPPES |
| C09633 | Other | VA | GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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