Organization
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Active
Parent organization
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Other names
Dominion Surgical Associates - Bon Secours Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Authorized official
GEORGE O. BUTLER MBA (DIRECTOR, CORPORATE RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
5855 BREMO RD, MOB NORTH, SUITE 406, RICHMOND, VA 23226-1930
(804) 285-4133
(804) 622-2224
Mailing address
5855 BREMO RD, MOB NORTH, SUITE 406, RICHMOND, VA 23226-1930
(804) 285-4133
(804) 622-2224
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
08/05/2009
Last updated
10/24/2018
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