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Physicians Internal Medicine

Provider NPI: 1609957240

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 804-828-2161  Fax: 804-828-2578

Business Mailing Address:
PO BOX 91734  RICHMOND, VA 23291-1734 US
Tel: 804-358-6100  Fax: 804-342-7619

NPI Information:
NPI: 1609957240
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Internal Medicine
Internal Medicine
Internal Medicine

Other Provider Identifiers:

006083323 541581185VA05

American Medical Association 2012 taxonomy code information

Code: 207R00000X





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