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Organization
SPOTSYLVANIA EMERGI-CENTER INC
Active
Organization
SPOTSYLVANIA EMERGI-CENTER INC
Active
Other names
SPOTSYLVANIA EMERGI-CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DESIDERIO LANDAS HEBRON M.D. (MEDICAL DIRECTOR)
(540) 786-7637
Entity
Organization
Contact information
Practice address
992 BRAGG RD, FREDERICKSBURG, VA 22407-6979
(540) 786-7637
(540) 786-0810
Mailing address
992 BRAGG RD, FREDERICKSBURG, VA 22407-6979
(540) 786-7637
(540) 786-0810
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101022289
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060133
ANTHEM BLUE CROSS GROUP
VA
01
—
060154
ANTHEM BLUE CROSS PPO
VA
Enumeration date
03/29/2007
Last updated
08/22/2020
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