| Mvag, Inc | |
|
7485 Poplar Pike Germantown TN 38138-5934 | |
| (901) 752-4999 | |
| (901) 752-3761 |
| Full Name | Mvag, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 7485 Poplar Pike, Germantown, Tennessee |
| Authorized Official Name and Position | Gregory Nathan Laurence (OWNER) |
| Authorized Official Contact | 9017524999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mvag, Inc 7485 Poplar Pike Germantown TN 38138-5934 Ph: (901) 752-4999 | Mvag, Inc 7485 Poplar Pike Germantown TN 38138-5934 Ph: (901) 752-4999 |
| NPI Number | 1396022463 |
|---|---|
| Provider Enumeration Date | 11/03/2011 |
| Last Update Date | 11/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396022463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD0000025017 (Tennessee) | Primary |
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