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Organization

MARY IMMACULATE HOSPITAL

Active
Parent organization
MARY IMMACULATE HOSPITAL
Other names
Bon Secours Gynecologic Oncology Specialists
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARY IMMACULATE HOSPITAL
Authorized official
MICHAEL K KERNER (CEO)
(757) 673-5929
Entity
Organization

Contact information

Practice address
500 SENTARA CIR, SUITE 102, WILLIAMSBURG, VA 23188-5727
(757) 984-9890
(757) 345-6659
Mailing address
500 SENTARA CIR, SUITE 102, WILLIAMSBURG, VA 23188-5727
(757) 984-9890
(757) 345-6659

Taxonomy

Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary

Other

Enumeration date
09/20/2011
Last updated
02/06/2012
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