# NMG AFFILIATE PRACTICE I, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novant Health UVA Health System Palliative Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154796696
- **Authorized official:** GEOFFREY K GARDNER (VP OF FINANCE)
- **Authorized official phone:** (703) 396-5292

## Contact information

- **Practice address:** 15225 HEATHCOTE BLVD, HAYMARKET, VA 20169-6264
- **Practice address phone:** (703) 396-5292
- **Practice address fax:** (703) 396-5297
- **Mailing address:** PO BOX 60447, CHARLOTTE, NC 28260-0447
- **Mailing address phone:** (703) 396-5292
- **Mailing address fax:** (703) 396-5297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | — | Yes |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 12/09/2015
- **Last updated:** 04/06/2016