Individual
MR. MICHAEL QUAY COGGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGPCNP-BC
Contact information
Practice address
5875 BREMO RD, MOB SOUTH, SUITE G-5, RICHMOND, VA 23226-1934
(804) 287-7840
Mailing address
5875 BREMO RD, MOB SOUTH, SUITE G-5, RICHMOND, VA 23226-1934
(804) 287-7840
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
0024172070
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
09/20/2014
Last updated
09/24/2014
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