Organization
NMG AFFILIATE PRACTICE I, LLC
Active
Other names
Novant Health Prince William Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFERY K GARDNER (VP OF FINANCE)
(704) 384-7606
Entity
Organization
Contact information
Practice address
8567 SUDLEY RD STE B, MANASSAS, VA 20110-3865
(703) 369-5959
(703) 369-7473
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(703) 369-5959
(703) 369-7473
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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