Organization
VIRGINIA BREAST CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES V PELLICANE JR. M.D. (PRESIDENT)
(804) 594-3130
Entity
Organization
Contact information
Practice address
13700 SAINT FRANCIS BLVD, STE 510, MIDLOTHIAN, VA 23114-3267
(804) 594-3130
(804) 594-3130
Mailing address
13700 SAINT FRANCIS BLVD, STE 510, MIDLOTHIAN, VA 23114-3267
(804) 594-3130
(804) 594-3130
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101045452
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10187419
—
VA
Enumeration date
12/05/2005
Last updated
08/22/2020
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