Organization
ST MARYS MEDICAL CENTER PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MEDHAT N ELMASRY MD (OWNER)
(276) 728-3332
Entity
Organization
Contact information
Practice address
430 WEST STUART DRIVE, HILLSVILLE, VA 24343
(276) 728-3332
(276) 728-3302
Mailing address
PO BOX 1805, HILLSVILLE, VA 24343
(276) 728-3332
(276) 728-3302
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101054724
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005855411
—
VA
01
—
441545
ANTHEM
VA
Enumeration date
08/25/2006
Last updated
03/05/2010
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