| Southside Internal Medicine | |
|
4103 Lafayette Blvd Suite 2 Fredericksburg VA 22408-4274 | |
| (540) 891-5550 | |
| Not Available |
| Full Name | Southside Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 4103 Lafayette Blvd, Fredericksburg, Virginia |
| Authorized Official Name and Position | Ashleigh A Raubenolt (CREDENTIALING) |
| Authorized Official Contact | 5403714488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Internal Medicine 4103 Lafayette Blvd Suite 2 Fredericksburg VA 22408-4274 Ph: (540) 891-5550 | Southside Internal Medicine 4103 Lafayette Blvd Suite 2 Fredericksburg VA 22408-4274 Ph: (540) 891-5550 |
| NPI Number | 1184952707 |
|---|---|
| Provider Enumeration Date | 11/19/2009 |
| Last Update Date | 11/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184952707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0102037027 (Virginia) | Primary |
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