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1510 N 28th St Ste 308 Richmond VA 23223-5311 | |
(804) 644-1665 | |
(804) 644-5285 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1510 N 28th St Ste 308, 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 |
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8580 Magellan Pkwy Richmond VA 23227-1149 Ph: (804) 627-5462 | 1510 N 28th St Ste 308 Richmond VA 23223-5311 Ph: (804) 644-1665 |
NPI Number | 1801829205 |
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Provider Enumeration Date | 07/09/2006 |
Last Update Date | 06/11/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801829205 | NPI | - | NPPES |
CG5286 | Other | VA | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (Virginia) | 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 | |