Individual
MARGO C BRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
120 EXECUTIVE CENTER PKWY, FREDERICKSBURG, VA 22401-3100
(540) 374-5200
Mailing address
2300 FALL HILL AVE, SUITE 215, FREDERICKSBURG, VA 22401-3342
(540) 374-5097
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110001678
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01596
MEDICARE GROUP NUMBER
—
Enumeration date
09/21/2007
Last updated
05/18/2011
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