Organization
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER INC
Active
Other names
Bon Secours Neurology Clinic at Memorial Regional
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHAN QUIRICONI (CFO)
(804) 281-8301
Entity
Organization
Contact information
Practice address
8266 ATLEE RD STE 330, MECHANICSVILLE, VA 23116-1812
(804) 325-8720
(804) 764-7351
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(804) 627-5462
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06115
GROUP PTAN
VA
Enumeration date
08/09/2012
Last updated
07/11/2019
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