Individual
MS. MAGGIE L. GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306
Mailing address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 510-6200
(540) 857-5306
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126002083
VA
363AS0400X
Surgical Physician Assistant
Primary
0110005514
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1
UNITED MINE WORKERS ASSOCIATION
VA
01
—
1689002834
MEDICAID QMB
VA
Enumeration date
10/25/2013
Last updated
06/09/2020
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