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Organization

MAPLE GROVE MEDICAL, INC.

Active
Other names
Rebecca Ingram, MD
Organization subpart
No

Provider details

NPI number
Authorized official
DR. REBECCA HARDING INGRAM M.D. (CEO, PHYSICIAN)
(804) 955-0965
Entity
Organization

Contact information

Practice address
316 MAPLE TREE LN, SPRING GROVE, VA 23881-8515
(804) 955-0965
Mailing address
316 MAPLE TREE LN, SPRING GROVE, VA 23881-8515
(804) 955-0965

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101242147
VA

Other

Enumeration date
05/16/2011
Last updated
05/16/2011
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