Organization
NMG AFFILIATE PRACTICE I, LLC
Active
Other names
Novant Health UVA Health System Urgent Care & Occupational Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY K GARDNER (VP OF FINANCE)
(703) 366-2590
Entity
Organization
Contact information
Practice address
6208 MULTIPLEX DR, SUITE 150, CENTREVILLE, VA 20121-5324
(703) 366-2590
(703) 366-2591
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
07/13/2016
Last updated
07/29/2016
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