Organization
PIEDMONT FAMILY PRACTICE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY VON ELTEN (CREDENTIALING)
(540) 347-4400
Entity
Organization
Contact information
Practice address
493 BLACKWELL RD, SUITE 202, WARRENTON, VA 20186-2639
(540) 341-1704
(540) 341-4766
Mailing address
493 BLACKWELL RD, SUITE 202, WARRENTON, VA 20186-2639
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101028495
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10035392
—
VA
05
—
10035414
—
VA
05
—
10035490
—
VA
05
—
10035503
—
VA
Enumeration date
05/23/2007
Last updated
08/22/2020
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