Organization
BON SECOURS VIRGINIA MEDICAL GROUP I, LLC
Active
Other names
Bon Secours Surgical Dermatology Center
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE BUTLER (DIRECTOR CORPORATE RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
5207 HICKORY PARK DR, SUITE A, GLEN ALLEN, VA 23059-2624
(804) 977-8938
(804) 762-7102
Mailing address
5207 HICKORY PARK DR, SUITE A, GLEN ALLEN, VA 23059-2624
(804) 977-8938
(804) 762-7102
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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