Organization
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Active
Other names
Liver Institute of Virginia - Bon Secours Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE O. BUTLER MBA (DIRECTOR, CORPORATE RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
12720 MCMANUS BLVD, SUITE 313, NEWPORT NEWS, VA 23602-4414
(757) 947-3190
(757) 947-3195
Mailing address
12720 MCMANUS BLVD, SUITE 313, NEWPORT NEWS, VA 23602-4414
(757) 947-3190
(757) 947-3195
Taxonomy
Speciality
Code
Description
License number
State
207RI0008X
Hepatology Physician
Primary
0101036976
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
MEDICARE GROUP PIN
VA
Enumeration date
01/25/2010
Last updated
10/24/2018
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