Organization
MEDIC 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AIMEE VANESSA HEGADORN (PRACTICE MANAGER)
(540) 371-1664
Entity
Organization
Contact information
Practice address
3429 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22408
(540) 371-1664
(540) 371-2411
Mailing address
3429 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22408
(540) 371-1664
(540) 371-2411
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110001678
VA
Other
Enumeration date
07/11/2006
Last updated
07/21/2022
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