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Organization
MEADOWCREST ENT AND FACIAL COSMETIC CENTER
Active
Organization
MEADOWCREST ENT AND FACIAL COSMETIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WAYNE GATES M.D. (PHYSICIAN)
(540) 433-9399
Entity
Organization
Contact information
Practice address
3360 EMMAUS RD, HARRISONBURG, VA 22801-2685
(540) 433-9399
(540) 433-1395
Mailing address
3360 EMMAUS RD, HARRISONBURG, VA 22801-2685
(540) 433-9399
(540) 433-1395
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101037916
VA
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006503403
—
VA
01
—
18364
OPTIMA ID
VA
01
—
462160
ANTHEM ID
VA
Enumeration date
05/18/2007
Last updated
02/11/2013
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