Organization
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Active
Other names
Bon Secours Pediatric Infectious Disease Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE O BUTLER (DIR. CORP. RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
5875 BREMO RD STE 303, MOB SOUTH, RICHMOND, VA 23226-1934
(804) 977-8914
(804) 281-0950
Mailing address
5875 BREMO RD STE 303, MOB SOUTH, RICHMOND, VA 23226-1934
(804) 977-8914
(804) 281-0950
Taxonomy
Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
08/08/2011
Last updated
10/24/2018
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