Individual
GABRIEL DAVID MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1401 JOHNSTON WILLIS DR STE 100, NORTH CHESTERFIELD, VA 23235
(804) 330-7990
(804) 330-2701
Mailing address
7202 GLEN FOREST DR STE 200, RICHMOND, VA 23226-3780
(804) 673-2024
(804) 673-1796
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1574
SC
207RH0003X
Hematology & Oncology Physician
Primary
0102205542
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015744
—
SC
05
—
1114289519
—
VA
01
—
VVV188A
MEDICARE PTAN
VA
Enumeration date
06/12/2012
Last updated
05/21/2021
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