| |
5855 Bremo Rd Ste 306 Richmond VA 23226-1923 | |
(804) 673-2814 | |
(804) 673-2873 |
Full Name | |
---|---|
Speciality | Internal Medicine - Infectious Disease |
Location | 5855 Bremo Rd Ste 306, Richmond, Virginia |
Authorized Official Name and Position | Stephan Quiriconi (CFO) |
Authorized Official Contact | 8042818301 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
8580 Magellan Pkwy Richmond VA 23227-1149 Ph: () - | 5855 Bremo Rd Ste 306 Richmond VA 23226-1923 Ph: (804) 673-2814 |
NPI Number | 1063772143 |
---|---|
Provider Enumeration Date | 05/22/2012 |
Last Update Date | 07/26/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063772143 | NPI | - | NPPES |
C06778 | Other | VA | GROUP PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | (* (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 | |