Organization
BELLGRADE MEDICAL
Active
Other names
Bellgrade Medical, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER GENT (PRESIDENT)
(804) 598-4799
Entity
Organization
Contact information
Practice address
2621 PROMENADE PKWY STE 101, MIDLOTHIAN, VA 23113-4905
(804) 897-3746
Mailing address
2621 PROMENADE PKWY STE 101, MIDLOTHIAN, VA 23113-4905
(804) 897-3746
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102032395
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102032395
STATE LICENSE
VA
Enumeration date
01/26/2018
Last updated
04/04/2018
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