Organization
VIRGINIA MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT S. DAVIS M.D. (PHYSICIAN)
(804) 526-0682
Entity
Organization
Contact information
Practice address
213 TEMPLE AVE, COLONIAL HEIGHTS, VA 23834-2827
(804) 526-0682
(804) 518-1168
Mailing address
2905 BOULEVARD, COLONIAL HEIGHTS, VA 23834-2400
(804) 520-0040
(804) 520-0043
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN0649
MEDICARE RAILROAD
VA
Enumeration date
11/01/2010
Last updated
11/01/2010
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