Individual
MARK VIRTUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 TURNER MCCALL BLVD SW, SUITE 101, ROME, GA 30165-5630
(706) 291-2745
Mailing address
420 E 2ND AVE, SUITE 103, ROME, GA 30161-3209
(706) 509-3000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
67625
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124619A
—
GA
05
—
003124619G
—
GA
Enumeration date
05/26/2009
Last updated
01/14/2014
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