# BON SECOURS DEPAUL MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BON SECOURS DEPAUL MEDICAL CENTER LLC
- **Other names:** DePaul Medical Associates
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619001906
- **Legal business name:** BON SECOURS DEPAUL MEDICAL CENTER LLC
- **Authorized official:** WILBUR GAY (CFO)
- **Authorized official phone:** (864) 561-7672

## Contact information

- **Practice address:** 155 KINGSLEY LN STE 400, NORFOLK, VA 23505-4629
- **Practice address phone:** (757) 278-2240
- **Practice address fax:** (757) 489-6469
- **Mailing address:** 8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
- **Mailing address fax:** (866) 449-0896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 03/16/2007
- **Last updated:** 09/22/2020