Organization
NMG AFFILIATE PRACTICE I, LLC
Active
Other names
Novant Health UVA Health System Lake Manassas OBGYN
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K. GARDNER (VP OF FINANCE)
(704) 384-7680
Entity
Organization
Contact information
Practice address
15195 HEATHCOTE BLVD, SUITE 338, HAYMARKET, VA 20169-6242
(571) 261-3270
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7680
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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