Organization
NMG AFFILIATE PRACTICE I, LLC
Active
Organization
NMG AFFILIATE PRACTICE I, LLC
Active
Parent organization
NMG AFFILIATE PRACTICE I, LLC
Other names
Novant Health UVA Health SystemDiabetes & Nutrition Manassas
Organization subpart
Yes
Provider details
NPI number
Legal business name
NMG AFFILIATE PRACTICE I, LLC
Authorized official
SHALA DAVIS (ENROLLMENT MNAAGER)
(704) 316-7845
Entity
Organization
Contact information
Practice address
8644 SUDLEY RD STE 315, MANASSAS, VA 20110-4425
(703) 369-8405
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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