Organization
MEADOWCREST ENT AND FACIAL COSMETIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WAYNE GATES M.D. (PHYSICIAN)
(540) 433-9399
Entity
Organization
Contact information
Practice address
3360 EMMAUS RD, HARRISONBURG, VA 22801-2685
(540) 433-9399
(540) 433-1395
Mailing address
3360 EMMAUS RD, HARRISONBURG, VA 22801-2685
(540) 433-9399
(540) 433-1395
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101037916
VA
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006503403
—
VA
01
—
18364
OPTIMA ID
VA
01
—
462160
ANTHEM ID
VA
Enumeration date
05/18/2007
Last updated
02/11/2013
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