Organization
BON SECOURS ST MARY'S HOSPITAL OF RICHMOND LLC
Active
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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