Organization
RIVERS EDGE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN MARIE KLECAN M.D. (DOCTOR)
(434) 295-3705
Entity
Organization
Contact information
Practice address
330 WINDING RIVER LANE, CHARLOTTESVILLE, VA 22911-3551
(434) 295-3705
(434) 295-3705
Mailing address
330 WINDING RIVER LANE, CHARLOTTESVILLE, VA 22911-3551
(434) 295-3705
(434) 295-3705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101054576
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010259231
—
VA
01
—
187671
ANTHEM
VA
01
—
408456
SOUTHERN HEALTH
VA
Enumeration date
01/19/2007
Last updated
06/02/2009
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