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Organization

MID-ATLANTIC ELDERCARE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRADLEY J GOAD DO (OWNER)
(276) 238-8876
Entity
Organization

Contact information

Practice address
5261 CARROLLTON PIKE, SUITE B, WOODLAWN, VA 24381-3030
(276) 238-8876
(276) 238-8886
Mailing address
5261 CARROLLTON PIKE, SUITE B, WOODLAWN, VA 24381-3030
(276) 238-8876
(276) 238-8886

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DN2980
GROUP PTAN
Enumeration date
10/05/2007
Last updated
09/24/2014
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