Organization
BON SECOURS ST MARY'S HOSPITAL OF RICHMOND LLC
Active
Other names
Bon Secours Associated Internists
Organization subpart
No
Provider details
NPI number
Authorized official
WILBUR GAY (CFO)
(864) 561-7672
Entity
Organization
Contact information
Practice address
7001 FOREST AVE, SUITE 405, RICHMOND, VA 23230-1726
(804) 288-3079
(804) 282-6159
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
03/02/2011
Last updated
09/04/2020
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