| Mission Functional Medicine, Pllc | |
|
230 Costello Dr Ste 210 Winchester VA 22602-4310 | |
| (540) 247-8476 | |
| (540) 869-3524 |
| Full Name | Mission Functional Medicine, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 230 Costello Dr Ste 210, Winchester, Virginia |
| Authorized Official Name and Position | Shawn C Lawson (OFFICE MANAGER) |
| Authorized Official Contact | 5402478476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission Functional Medicine, Pllc 103 Chancellorsville Dr Stephens City VA 22655-4515 Ph: (540) 247-8476 | Mission Functional Medicine, Pllc 230 Costello Dr Ste 210 Winchester VA 22602-4310 Ph: (540) 247-8476 |
| NPI Number | 1225514136 |
|---|---|
| Provider Enumeration Date | 07/13/2018 |
| Last Update Date | 07/13/2018 |
| Medicare PECOS PAC ID | 8921347972 |
|---|---|
| Medicare Enrollment ID | O20190308001321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225514136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0102202773 (Virginia) | Primary |
| Provider Name | Laura Nelson Lawson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295869543 PECOS PAC ID: 9335231927 Enrollment ID: I20110601000447 |
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