Organization
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER
Active
Parent organization
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER
Other names
RICHMOND DIABETES AND ENDOCRINOLOGY, Richmond Diabetes and Endocrinology - Bon Secours Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER
Authorized official
STEPHAN QUIRICONI (CFO)
(804) 281-8301
Entity
Organization
Contact information
Practice address
8266 ATLEE RD STE 332, MECHANICSVILLE, VA 23116-1812
(804) 764-7686
(804) 764-7689
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(804) 627-5462
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06115
GROUP PTAN
VA
Enumeration date
05/26/2009
Last updated
05/24/2019
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