Organization
BON SECOURS-VIRGINIA HEALTHSOURCE INC
Active
Other names
BON SECOURS SURGICAL SPECIALIST AT ST MARY'S HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHAN QUIRICONI (CFO)
(804) 281-8301
Entity
Organization
Contact information
Practice address
5855 BREMO RD STE 506, RICHMOND, VA 23226-1925
(804) 285-3225
(804) 285-0360
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(804) 627-5462
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06695
GROUP PTAN
VA
Enumeration date
12/08/2011
Last updated
06/14/2019
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