| Grace Family Medicine Clinic | |
|
300 Moore St Suite A Bristol VA 24201-4495 | |
| (276) 644-4433 | |
| (276) 644-4434 |
| Full Name | Grace Family Medicine Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 Moore St, Bristol, Virginia |
| Authorized Official Name and Position | Uzoma Obuekwe (MEDICAL DIRECTOR / OWNER) |
| Authorized Official Contact | 2764945225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Family Medicine Clinic 200 Harvest Rd Bristol VA 24201-5109 Ph: (276) 494-5225 | Grace Family Medicine Clinic 300 Moore St Suite A Bristol VA 24201-4495 Ph: (276) 644-4433 |
| NPI Number | 1407293954 |
|---|---|
| Provider Enumeration Date | 05/23/2013 |
| Last Update Date | 09/04/2013 |
| Medicare PECOS PAC ID | 1557595352 |
|---|---|
| Medicare Enrollment ID | O20131114000002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407293954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0101244053 (Virginia) | Primary |
| Provider Name | Uzoma Nwanagu Obuekwe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992901409 PECOS PAC ID: 4880720838 Enrollment ID: I20100329000770 |
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