Organization
NMG AFFLIATE PRACTICE I, LLC
Active
Parent organization
NMG AFFLIATE PRACTICE I, LLC
Other names
UVA Spine Manassas
Organization subpart
Yes
Provider details
NPI number
Legal business name
NMG AFFLIATE PRACTICE I, LLC
Authorized official
SHALA DAVIS (RCS MANAGER)
(704) 303-7517
Entity
Organization
Contact information
Practice address
8525 ROLLING RD STE 300, MANASSAS, VA 20110-3673
(704) 384-7246
Mailing address
PO BOX 936952, ATLANTA, GA 31193-6952
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
09/14/2021
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