Organization
CENTRAL VIRGINIA GYNECOLOGIC ONCOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL LYNN SEGURA (PRACTICE MANAGER)
(804) 323-5040
Entity
Organization
Contact information
Practice address
9101 STONY POINT DR # 3300, RICHMOND, VA 23235-1979
(804) 323-5040
(804) 272-0526
Mailing address
1401 JOHNSTON WILLIS DR STE 1100, NORTH CHESTERFIELD, VA 23235-4730
(804) 323-5040
(804) 323-5070
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006215149
—
VA
Enumeration date
08/27/2019
Last updated
08/29/2019
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