Organization
MEDIDOCTORS PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT K LIVELY (EXECUTIVE DIRECTOR)
(540) 741-1473
Entity
Organization
Contact information
Practice address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(540) 741-1428
(540) 741-1420
Mailing address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(540) 741-1428
(540) 741-1420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
Other
Enumeration date
05/23/2006
Last updated
10/17/2007
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