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Organization
WISE MEDICAL GROUP
Active
Organization
WISE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROMULO ABRANTES FAJARDO MD (PHYSICIAN)
12763955983
Entity
Organization
Contact information
Practice address
203 FRONT ST WEST, COEBURN, VA 24230
(276) 395-5983
(276) 395-5986
Mailing address
PO BOX 1734, 203 FRONT ST. WEST, COEBURN, VA 24230-1734
(127) 639-5598
(127) 639-5598
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101221509
VA
Other
Enumeration date
02/07/2007
Last updated
08/22/2020
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