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Organization
NMG AFFILIATE PRACTICE I, LLC
Active
Organization
NMG AFFILIATE PRACTICE I, LLC
Active
Other names
Novant Health UVA Health System Bristow Run Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY GARDNER (VP OF FINANCE)
(703) 753-9799
Entity
Organization
Contact information
Practice address
14540 JOHN MARSHALL HWY, SUITE 104, GAINESVILLE, VA 20155-1691
(703) 753-9799
(703) 753-9792
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(703) 753-9799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/22/2013
Last updated
04/06/2016
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