Organization
MOUNTAINSIDE MEDICINE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN F. MCCUE D.O. (PRESIDENT)
(540) 675-3080
Entity
Organization
Contact information
Practice address
12715 LEE HWY, WASHINGTON, VA 22747-1933
(540) 675-3080
Mailing address
12715 LEE HWY, WASHINGTON, VA 22747-1933
(540) 675-3080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102049877
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5624215
—
VA
Enumeration date
02/04/2008
Last updated
02/04/2008
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