# NMG AFFILIATE PRACTICE I, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UVA Obstetrics and Gynecology Fletcher Drive
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750813812
- **Authorized official:** SHALA DAVIS (RCS MGR)
- **Authorized official phone:** (704) 303-7517

## Contact information

- **Practice address:** 480 FLETCHER DR, SUITE 3, WARRENTON, VA 20186-2185
- **Practice address phone:** (571) 261-3529
- **Practice address fax:** (703) 753-5613
- **Mailing address:** PO BOX 936952, ATLANTA, GA 31193-6952

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/29/2017
- **Last updated:** 09/14/2021